Doctors Report Potential Link Between COVID-19, Rising Stroke Risk

Unusual cases of extremely healthy people suffering from stroke have been reported in the United Kingdom and other countries amid the COVID-19 pandemic. Doctors believe that the novel coronavirus played a role in those cases that put patients at risk of death. 

There is a growing number of people contracting COVID-19 in the U.K. Part of the increase is “a distinctive pattern” of stroke incidents associated with the virus, according to David Werring, a professor of clinical neurology, and Arvind Chandratheva, a consultant neurologist and honorary associate professor, both from University College London (UCL). 

One patient that recently experienced the two health problems is a man named John. Werring and Chandratheva found his case surprising since he suffered from an acute stroke despite being fit and physically active and not having other risk factors, like smoking. 

But John previously recovered from COVID-19. He was about to return home from the hospital when he experienced a series of blood clots in his lung, in legs and brain, which led to stroke.

Werring and Chandratheva said it was not the first time they saw a fit and healthy patient experience many blood clots in rapid succession. In April, they treated six people with COVID-19 and similar acute strokes.

Five of the patients had a stroke more than a week after showing COVID-19 symptoms, while one patient had blood clots before having the symptoms. All of them appeared with high blood levels of a protein fragment called D-dimer, which is linked to abnormal blood clotting. 

Doctors also found the patients had raised levels of ferritin and C-reactive protein in the blood, which indicated an exaggerated inflammatory response to the coronavirus. 

“We were witnessing the unfolding of a distinctive pattern of stroke associated with the COVID-19 pandemic,” Werring and Chandratheva said in an article posted on the Conversation. “It was becoming clear that COVID-19 is not just a respiratory disease, and that these blood-clot complications were part of an inflammatory state.”

The two experts cited other cases in New York involving five patients that suffered from stroke due to “large artery occlusions” and high levels of blood-clotting markers. Some COVID-19 patients also experienced the same conditions in Wuhan, China. 

Werring and Chandratheva explained that the coronavirus infection potentially causes stroke because of the immune system’s response to the virus. The body releases a significant amount of inflammatory molecules to fight the infection, which could trigger blood clotting.

The novel coronavirus also attaches to proteins on cells called ACE2 receptors. These cells are involved in the body’s blood pressure control systems.

“The direct invasion of endothelial cells could also cause blood vessel inflammation (vasculitis),” Werring and Chandratheva said. “Once we have a better understanding of these mechanisms, it might be possible to target specific phases of COVID-19 to prevent devastating vascular complications.”

The experts plan to launch a study in the U.K. to further understand the link between stroke and COVID-19. The effort also aims to develop a treatment using a marker of the amount of blood clotting, called  D-dimer, on coronavirus patients.

Coronavirus COVID-19 New York, USA A worker uses a forklift to move a body outside of the Brooklyn Hospital on March 31, 2020 in New York, United States. Due to a surge in deaths caused by the Coronavirus, hospitals are using refrigerator trucks as make shift morgues. Stephanie Keith/Getty Images