Photo: dpa
BerlinCovid-19 is primarily considered a lung disease. Because the viruses affect the respiratory tract. However, the more patients there are worldwide, the more complex the clinical picture of the disease becomes. The latest observation: the insidious virus also leads to an increase in strokes – sudden blood circulation problems in the brain, which are often triggered by blood clots.
This is not just about patients who are particularly seriously ill with Covid-19 and who are already being treated in the hospital. Rather, these corona-typical strokes apparently also occur in relatively young patients between the ages of 30 and 50 who initially fought the disease at home and actually have no risk factors for a stroke.
At least, these are the observations of doctors from New York, Barcelona, Lombardy and other regions who are particularly badly affected by the pandemic. According to a report by the US newspaper Washington Post, several clinics in New York City have had conspicuously young patients with severe strokes and Sars CoV-2 infection in recent weeks. Mount Sinai Hospital physicians appear to have documented five such cases and submitted their report for publication in the New England Journal of Medicine.
As the US newspaper reports, it is patients between the ages of 33 and 49 who suddenly experienced neurological disorders such as hemiplegia, arm discomfort and slurred speech at home. They found severe strokes in the clinic – and Covid-19. One of the five patients has died, two are still in the hospital, two others have been discharged into rehabilitation or home care. Only one of those affected, a 33-year-old woman, is now able to speak again.
In Germany, this complication is now known, but so far it has been observed only occasionally. “This phenomenon has been reported in conference calls with international colleagues for a good three weeks,” says Matthias Endres, Director of the Charité Neurological Clinic and at the Center for Stroke Research. It is often a particularly severe form of stroke, which is caused by occlusions of the large brain vessels.
There have been four Covid 19 patients at the Charité who have had a stroke. Three of the cases are particularly severe disease courses in younger patients in the intensive care unit. Only one of the cases was an older patient who was admitted to the Charité with a severe stroke and was then diagnosed with a Sars-CoV-2 infection, reports Endres.
So the phenomenon is not common in this country. “This is probably simply because we have had relatively low Sars CoV-2 infections so far,” says the Charité professor. He explains the increased incidence of corona-related strokes, an increased tendency for the blood to clot and damage to the vascular cells. “This is a typical episode of Covid-19. This not only increases the number of strokes, but also venous thrombosis and pulmonary embolism, ”says the neurologist.
Apparently, it was decided seven to ten days after the onset of symptoms whether a Covid 19 patient was over the mountain or whether his condition was getting worse. “As the disease progresses, there can be a sharp increase in the production of inflammatory messengers, also called the cytokine storm. The coagulation activity then often increases, ”explains the doctor. It is still unclear which mechanisms are behind this in detail.
Research is now important to find out more about the variants and complications of Covid-19, Endres emphasizes. At the Charité, for example, there is now a cohort with more than 100 patients, in whom all organ systems are examined and whose condition is followed up several months after recovery. “The neurological clinic is also involved in this study called PA-Covid-19,” says Endres. Likewise, together with the German Society for Neurology, one is involved in the Germany-wide survey of neurological complications in LEOSS deep, the European registry for Covid-19.
So far it cannot be said whether, for example, genetic factors favor Covid complications in the area of blood coagulation. Endres therefore advises younger age groups not to protect the corona risk. “Infected people should not hesitate to go to the hospital if their condition worsens,” says Endres. Especially when there are neurological failures such as paralysis, emotional disorders or changes in consciousness, there is only one choice: 112.
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