A new small preliminary study has found that young and otherwise healthy patients with COVID-19 may have an increased risk of stroke, even if they are not showing any symptoms of the virus.
Surgeons at Thomas Jefferson University Hospital along with researchers at other medical institutions looked at 14 patients who had come into their care for stroke between March 20 and April 10, during the current COVID-19 pandemic.
Of the patients, which included eight men and six women, 50 percent did not know that they had the coronavirus while the rest were already being treated for symptoms of the disease.
The researchers found that 42 percent of the COVID-19 stroke patients were under the age of 50, whereas 75 percent of all strokes in the US occur in people over the age of 65. Moreover, the mortality rate among the COVID-19 stroke patients was 42.8 percent, much higher than the typical mortality from stroke which is around 5 to 10 percent.
The patients also experienced stroke in large vessels in both hemispheres of the brain and in both arteries and veins of the brain, which the researchers say is unusual to see in stroke patients.
Worrisomely, patients with signs of stroke were also likely to delay going to the hospital for fear of contracting COVID-19 while they were there, but as there is a small window of time for treating strokes, any delays can be life-threatening say the researchers.
"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," says senior author Pascal Jabbour, MD.
"Although we have to stress that our observations are preliminary, and based on observations from 14 patients, what we have observed is worrying," says Dr. Jabbour. "Young people, who may not know they have the coronavirus, are developing clots that cause major stroke."
The researchers explain that the findings, which are published in the journal Neurosurgery, could be due to the fact that the coronavirus enters human cells via a protein on the cells called ACE2. In addition to using this protein as a gateway to get into cells and replicate, the virus could also be interfering with the protein's normal function, which controls blood flow in the brain.
"Our observations, though preliminary, can serve as a warning for medical personnel on the front lines, and for all of those at home," says Dr. Jabbour. "Stroke is occurring in people who don't know they have COVID-19, as well as those who feel sick from their infections. We need to be vigilant and respond quickly to signs of stroke."