COVID-19 linked to stroke risk in healthy young people: Study

Healthy young people may have an increased risk of stroke if they are infected with the novel coronavirus that causes COVID-19, whether or not they are showing symptoms of the disease, according to a small observational study.

The researchers at Thomas Jefferson University in the US, and colleagues analysed COVID-19 patients with stroke from March 20 until April 10 at their institutions. The strokes they observed were unlike what they usually see, according to the study published on Thursday in the journal Neurosurgery. “We were seeing patients in their 30s, 40s, and 50s with massive strokes, the kind that we typically see in patients in their 70s and 80s,” said Pascal Jabbour from Thomas Jefferson University.

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The study examined and characterised strokes in patients who tested positive for COVID-19, done in collaboration with surgeons from NYU Langone Medical Center in New York, US.
“Although we have to stress that our observations are preliminary, and based on observations from 14 patients, what we have observed is worrying,” said Jabbour. “Young people, who may not know they have the coronavirus, are developing clots that cause major stroke,” he said. The researchers examined 14 patients who had come into their neuro-interventional room for stroke.

Eight patients were male, six were female, 50 percent did not know they had the coronavirus, while the remainder were already being treated for other symptoms of the disease when they developed stroke. Previous studies have shown that the coronavirus enters human cells via a very specific access point — a protein on human cells called ACE2, the researchers noted. However, the coronavirus latches onto this protein and uses it as a gateway into the cell, where the virus can replicate, they said.

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Jabbour and colleagues speculate that the virus may be interfering with this receptor’s normal function, which controls blood flow in the brain, in addition to using it as an entry point to the cell. Another possibility, the researchers said, is that the inflammation of the blood vessels causing vasculitis with injury to the cells lining the lumen of the vessel called the endothelium and causing micro thrombosis in small vessels.