By Dr. Monica Scarsella, Vascular Neurologist, Bronson Neuroscience Center
When the COVID-19 pandemic began, little was known about the effects of the virus. Today, we have a better understanding of what these effects are and how to manage them.
You may already know some of the long-term issues caused by the virus, such as brain fog, fatigue and breathing problems, but did you know that it can increase your risk of having a stroke?
Stroke has become a known problem of COVID-19, with studies showing that the risk increases three days after symptoms of the virus begin. We also now know that the risk remains high for up to one year after having the virus.
Why does COVID-19 increase stroke risk?
The reason has to do with your body’s response to the virus. Normally, your immune system reacts to inflammation from an injury like a scrape or cut by clotting the blood. For some with COVID-19, generalized inflammation inside the body can lead to dangerous blood clots that travel to the brain and cause ischemic stroke.
The COVID-19 virus can also invade the wall of blood vessels. This causes them to weaken and ultimately rupture, resulting in a hemorrhagic stroke.
Who is at risk of COVID-related stroke?
Studies have shown that both older and younger adults have a higher risk of stroke due to COVID-19. The risk is even higher for those with pre-existing health conditions such as diabetes and high blood pressure.
After a COVID-related ischemic stroke, some patients were found to have more disability. Factors that may contribute to this include: Being over age 55, high blood sugar levels, kidney dysfunction, and a prior abnormal neurological exam (weakness, numbness, vision, speech or balance/coordination difficulty).
People over the age of 65 with certain comorbid conditions have more risk of ischemic stroke regardless of COVID-19. This includes having: High blood pressure, diabetes, coronary artery disease, atrial fibrillation, high cholesterol, congestive heart failure, obstructive sleep apnea, and other conditions that cause an increased risk of blot clots, such as cancer and infection.
Risk factors for COVID-related hemorrhagic stroke include: Taking blood thinning medication and needing mechanical ventilation or extracorporeal membrane oxygenation (ECMO).
How is a COVID-related stroke treated?
Treatment for COVID-19 related stroke is the same as for any other stroke. This includes, in some cases, giving the patient a powerful blood thinner, tPA, or surgically removing a clot.
Recovery after stroke varies based on stroke severity. Strategies for future stroke prevention and recovery can include: Blood thinning medication, physical therapy, occupational therapy, and speech therapy.
What are the symptoms of a stroke?
Symptoms depend on which part of the brain is affected and can range from mild to severe. Common symptoms include: Sudden numbness or weakness in the face, arm or leg; trouble speaking or understanding speech; vision problems; balance or coordination issues; and severe headaches.
BE FAST
The faster you’re diagnosed and treated, the better your outcome will be. That’s why it’s important to BE FAST. When someone with a stroke is brought to any one of Bronson’s hospitals in an ambulance, the stroke team is notified so they can be prepared for immediate intervention.
Balance. Vertigo or you’re feeling dizzy or falling to one side.
Eyes. Loss of vision or blurred vision.
Face. Facial drooping to one side.
Arms. Weakness in the arms, leg or face.
Speech. Slurred or doesn’t make sense.
Time. Act quickly if you notice any of these symptoms and call 9-1-1 right away. This is the fastest and safest way to get to the hospital.
There are times that these symptoms turn out not to be a stroke. If you’re not sure, ask someone who is around to look at you. They should check your smile to see if there is facial drooping. Have them watch you hold out your arms to see if one is drifting. If so, you should call 9-1-1. If no one is around to help you or you’re in doubt, it’s best to call 9-1-1 to be safe.
How to decrease the overall risk of stroke.
Whether you’ve had COVID-19 or not, taking proactive steps to improve your health is the best way to reduce the risk of any stroke. Some lifestyle changes to make would be: Exercising regularly, adopting the Mediterranean diet, quitting smoking, losing weight, and avoiding excessive alcohol.
It’s also important not to delay routine care. Your primary care provider can help you get ahead of health conditions that could increase your risk of stroke. If you don’t have a primary care provider, visit bronsonhealth.com/find-a-doc.
Dr. Monica Scarsella is a vascular neurologist at the Bronson Neuroscience Center which has offices in Battle Creek and Kalamazoo. Dr. Scarsella also sees patients via telehealth at Bronson Battle Creek Hospital. Patients who come to any Bronson hospital after suffering a stroke will find a wide range of treatments and services. The stroke team, including vascular neurology, neuroendovascular surgery, neuro intensive care, neurosurgery and emergency care providers all work together to deliver immediate, life-saving care. For more information on stroke care at Bronson visit bronsonhealth.com/services/neurology/treatments/stroke/
