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Could COVID-19 Be Causing Strokes? Know the Signs

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R. Todd Hurst, MD, FACC, FASE - Blogs
By R. Todd Hurst, MD, FACCBoard-certified cardiologistApril 27, 2020

A new, and frightening, expression of COVID-19 infection has surfaced. Numerous physicians around the world are reporting a possibly increased risk for blood clots in patients with COVID-19.

Blood clots (what doctors call thrombosis) are particularly worrisome because of the potential consequences. Blood clots in the veins can travel to the lungs (which is called pulmonary embolus), a potentially life-threatening problem. Blood clots in the arterial system are even more alarming because these can lead to heart attacks, strokes, and amputations.

COVID-19 appears to increase blood clots in both the arteries and the veins. Although all of the studies are small and observational at this point, one study from the Netherlands showed that 31% of subjects with COVID-19 in the ICU developed blood clots despite usual measures to prevent clotting. Another small study from China showed that 25% of the COVID-19 patients developed blood clots in the veins. These are shockingly high numbers.

Physicians are particularly troubled by this possible blood clotting issue for several reasons. One is that the usual treatments (such as blood thinner medications) aren’t working for some patients. Another reason is the report of COVID-19 positive people as young as their 30’s experiencing large strokes that are more typically seen in a much older population.

More information is needed to understand if this is a true correlation between COVID-19 and blood clotting disorder, what the mechanism is, and, most importantly, how to prevent and treat it. 

For now, be aware that there’s reason to suspect that COVID-19 could possibly put any of us at risk for stroke.

So, be alert for stroke symptoms – sudden weakness, numbness, trouble speaking, seeing, or the onset of a severe headache without other explanation – even if you wouldn’t ordinarily need to be concerned about stroke risk, and even without other signs of COVID-19 infection.

If you do experience symptoms that may be stroke-related, it is critically important to seek urgent medical attention. Timing is crucial because the best treatments for these types of stroke need to be delivered in the first 3 hours of symptoms to be most effective. As stroke neurologists like to say, “Time is brain.”

And if you suspect a stroke in someone else, act F.A.S.T.:

F.A.S.T. stands for:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T—Time: If you see any of these signs, call 9-1-1 right away.

Understandably, some are reluctant to go to the hospital during the COVID-19 pandemic, but when it comes to a stroke, the consequences of delaying medical treatment could be devastating. Do not delay. Call 911 if anyone has these symptoms.

 

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About the Author
R. Todd Hurst, MD, FACC

R. Todd Hurst, MD, FACC, FASE, is a board-certified cardiologist, director of the Center for Cardiovascular Health at Banner – University Medicine Heart Institute, and associate professor of medicine at the University of Arizona. He has written more than 50 publications in peer-reviewed journals and regularly speaks nationally and internationally at medical meetings, primarily on the prevention of heart disease.

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