Stroke seems 8 times more likely with COVID than flu

Both the flu and COVID-19 can increase the risk of stroke, but the odds appear to be eight times higher with the coronavirus, according to a new study.

Among more than 1,900 patients with COVID-19, 1.6% suffered a stroke, compared to 0.2% for nearly 1,500 seriously ill patients with the flu, the researchers found.

“Physicians and professionals caring for patients with COVID-19 infection should remain vigilant for the signs and symptoms of a stroke, because prompt diagnosis can allow effective treatment of stroke,” said researcher Dr. Neal Parikh, assistant professor of neurology and neuroscience at Weill Cornell Medicine in New York City.

“Fundamentally, our results support the idea that COVID-19 infection is more serious than influenza infection,” added Parikh.

For the study, Parikh and colleagues compared the incidence of stroke between COVID patients and flu patients at two New York City hospitals. Coronavirus patients were screened from March 4 to May 2, while researchers analyzed flu data from January 1, 2016 to May 31, 2018.

Two neurologists who reviewed the findings were not surprised that COVID was linked to a stroke.

“Infections and other inflammatory conditions are established risk factors for stroke, so it is not surprising that patients with COVID-19 disease may have a stroke as a complication of the infection,” said Dr. Larry Goldstein, professor and president of neurology at the University. from Kentucky

COVID-19 disease has also been associated with blood clots that could increase the risk of stroke, he said.

Dr. Salman Azhar is director of stroke at Lenox Hill Hospital in New York City. He said: “This virus has a predilection for causing a certain level of clotting, and we believe that it may be due to increased inflammation in the body.”

Azhar explained that COVID-19 attacks the cells that line the blood vessels, which is one of the reasons for the increased risk of blood clots leading to a stroke. In addition, the virus increases the production of clotting factors, he said.

Antibodies also play a role in the development of stroke, Azhar said.

“There are antibodies that we have known for a long time, nothing to do with this virus, but we know that it increases the risk of people suffering from strokes and other blood vessel clots, and we see them with a higher incidence in patients with COVID-19 Azhar said.

Due to these risks, patients with COVID-19 are monitored for signs of clotting. Overall, “every COVID-19 patient gets low-level blood thinners to try to prevent clots,” Azhar said.

“Clotted patients receive higher doses of anticoagulants to prevent them from having clots that can damage vital organs,” he said.

Both young and old patients with COVID can develop clots, and the sickest are at higher risk, Azhar said.

Stroke may be the first sign of COVID-19 in some patients. In this study, more than a quarter of patients went to the emergency room due to a stroke and were later diagnosed with the coronavirus.

Fortunately, only a small percentage of COVID-19 patients have strokes, Azhar said. Of 1,916 patients who had the virus in the study, 31 suffered a stroke. However, disability after a stroke can be a lasting effect of the virus, he said.

Not all parts of the country have seen the same stroke risk in COVID patients that was reported in New York, said Goldstein, whose practice is in Lexington, Ky.

“We still have to have a single patient with both conditions, although the number with COVID-19 in our area is, fortunately, much lower than in New York,” he said. “Regardless, COVID-19 disease is clearly associated with a propensity for blood clotting, and stroke should be considered as a possible complication.”

The report was published online July 2 in the magazine. JAMA Neurology.

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