Doctors at Mt. Sinai Health System in New York City, which has one of the highest rates of COVID-19 in the country, have reported 5 cases of stroke within a two-week period in patients ages 33 to 49 who were subsequently diagnosed with COVID-19. The information was presented in a “rapid communication” in the Journal of the American Medical Association (JAMA).**
The patients had no to mild COVID-19 symptoms. One patient did have a history of stroke.
By comparison, every 2 weeks over the previous 12 months, Mt. Sinai Health System treated, on average, 0.73 patients younger than 50 years of age with large-vessel stroke.
Dr. Thomas J. Oxley, MD, PhD, in the Department of Neurosurgery at the Mt. Sinai Health System, said it appears that COVID-19 may be causing blood clotting.
The doctors who signed the paper noted that stroke appears to be a factor in COVID-19 cases in China and Singapore.
Two of the patients had delayed going to the hospital because of the pandemic, which could have resulted in poorer outcomes. The doctors say that plus social isolation and distancing may be resulting in fewer patients presenting at the hospital with stroke.
A separate report out of the Netherlands, published in Thrombosis Research, also described increased rates of thrombotic (ie blood clot) complications in 184 critically ill COVID-19 patients with pneumonia, citing a 31% rate of thrombotic complications. The report says this may be due to to excessive inflammation, hypoxia, im-mobilisation and diffuse intravascular coagulation.
** The Journal of the American Medical Association says: To rapidly communicate information on the global clinical effort against Covid-19, the Journal has initiated a series of case reports that offer important teaching points or novel findings. The case reports should be viewed as observations rather than as recommendations for evaluation or treatment. In the interest of timeliness, these reports are evaluated by in-house editors, with peer review reserved for key points as needed.
