Stroke in otherwise healthy young people linked to Coronavirus

A high incidence of stroke seen in younger patients who were otherwise healthy linked to COVID-19 infection

Young patients with no risk factors for stroke may have an increased risk if they have contracted COVID-19. Many of these healthy young adults may not have any symptoms of the disease. Most of these strokes were major stroke involving large areas of the brain in both hemispheres, hence associated with increased mortality.

Researchers analyzed 14 patients presenting with stroke from March 20th until April 10th at their institutions. Eight patients were male, six were female, 50%, did not know they had the coronavirus, while the remainder were already being treated for other symptoms of the disease when they developed a stroke. The strokes they observed were unlike what they usually see. 

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

“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 lead author,  Pascal Jabbour, MD, Chief of the Division of Neurovascular Surgery and Endovascular Surgery at  Jefferson Health. 

Some highlights of the paper :

1. Patients with signs of stroke were delaying coming to the hospital for fear of getting the coronavirus. There’s a small window of time in which strokes are treatable, so delays can be life threatening.

2. The mortality rate in these covid-19 stroke patients is 42.8%. The typical mortality from stroke is around 5 to 10%.

3. 42% of the stroke coronavirus positive patients studied were under the age of 50. Most strokes, over 75% of all strokes in the US, occur in people over the age of 65.

4. The incidence of coronavirus in the stroke population was 31.5%, according to this sample of patients.

5. Patients observed had strokes in large vessels, in both hemispheres of the brain, and in both arteries and veins of the brain – all of these observations are unusual in stroke patients.

“Young people, who may not know they have the coronavirus, are developing clots that cause major stroke. Our observations, though preliminary, can serve as a warning for medical personnel on the front lines, and for all of those at home,” said 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.”