Stroke is said to start in young patients (30-50 years old) with Covid-19. A risk especially reported in the asymptomatic forms of this coronavirus.
Covid-19 has the sad power to reach multiple organs. The lungs, kidneys, heart, intestinal system … and the brain. The most commonly reported neurological symptom is loss of taste and smell. But another phenomenon is beginning to be reported by neurologists: the possible correlation between a Covid-19 infection and the occurrence of a stroke.
Read also :
FISHING INFO. Coronavirus disease in children? Cases noted in France and pediatricians on alert
Thus, on April 22, Dr. Benoît Guillon, neurologist responsible for the neurovascular unit at the Nantes University Hospital, reported a slight increase in stroke cases in the young population, “without definite cause, without being able to confirm a direct link with the Covid-19 “, given” the lack of perspective on this incidence “.
But the lines move quickly in the world of the Covid-19. Today, cases certainly remain infrequent in France. But as a precaution, “the alert is given by vascular neurologist doctors,” says Dr. Guillon. “Young patients who are positive for Covid-19, with no risk factor *, seem to present atypical pictures with thromboses, relatively diffuse, rather unusual arterial occlusions.” Importantly, “these patients in some cases show little or no symptoms of Covid-19”.
“Cut the chains of contamination”
But how do you explain it? “Either asymptomatic patients declare this stroke when Covid-19 has already evolved well. Or this serious neurological complication constitutes a gateway to the disease”, for this young population suffering neither from cough, nor from headache, nor respiratory discomfort. In all cases, the risk of stroke must be taken into account “to detect the coronavirus as soon as possible and be able to cut the chains of contamination”.
Home stroke
On the other side of the Atlantic, the Washington Post revealed, on April 25, these same neurological accidents in New York in patients aged 30 to 50 years. And on April 28, a study, or rather a case study, published in the New England Journal of Medicine (NEJM) support this phenomenon. The team of Dr. Thomas J. Oxley ** describes 5 cases of stroke that occurred between March 23 and April 7, at home, in young people aged 33, 37, 39, 44 and 49 years respectively *** . All were positive for Covid-19. One of them died, one is in rehabilitation, two are still hospitalized and only the 33-year-old patient is able to speak. She suffered from episodes of cough, headache and chills the week before her hospitalization.
According to the researcher, “Covid-19 patients reporting a stroke were on average 15 years younger compared to the strokes diagnosed in diseases outside Covid-19”. Finally, “the number of young people admitted to the emergency room for cerebral blood clotting disorders doubled in 3 weeks at the Mount Sinai Hospital (New York)”, adds Dr. Mocco, also participating in the work published in the NEJM. And this “despite a decline in emergency care”.
Physiologically, what is the origin of these complications? “Covid-19 could promote the formation of blood clots.” Are there data available on the risk of stroke from other forms of coronavirus? Yes, “in 2004 in Singapore, SARS-CoV-1 caused stroke,” says Dr. Oxley. “In 2012, in the Middle East, during the MERS-CoV epidemic, pictures of brain damage were described, with the same appearance as those reported for Covid-19”, explains Dr Guillon from Nantes University Hospital.
And after ?
Regarding Covid-19, “other studies must be carried out,” supports Dr. Oxley. To date, “it seems to me too early to consider that these strokes in young people, which still occur very rarely, are linked to Covid -19 “, says Dr. Caroline Arquizan, head of the neurovascular unit at the Montpellier University Hospital.” The study published in the NEJM only includes 5 cases of stroke, this is not representative. “The risk is it that today we put everything on the back of the Covid-19? “It is possible that some publications are going too fast indeed.”
“We saw a drop in stroke in March and early April. And today there is talk of an increase in stroke among young people without any convincing evidence.” To clarify things, “we are going to launch a national study comparing the rates of admissions for stroke on the one hand and of cardiovascular accidents on the other hand, between the figures of the epidemic phase of Covid-19 and those of the year spent in the same period. ” Data (incidence, type of stroke and myocardial infarction, age, access to treatment, etc.) will be collected in the 13 regions of France, within neurovascular units and intensive care cardiological units.
To note : the warning symptoms of a stroke, requiring a call to the emergency room on the 15th, are characterized by the sudden onset of loss of sensitivity or paralysis of one or more limbs, of the face, usually one side. Other abnormalities include severe and brutal headache, impaired vision, speech and balance. “The management of a stroke must occur as early as possible to be effective, ideally within 6 hours without exceeding the 24-hour period,” said Professor Oxley.
–
