Covid-19 can cause stroke in absence of comorbidities, say neurologists

Covid-19 is typically known as a lung infection, but it has also been found to cause blood clots that can lead to severe stroke. And neurologists indicate that there is proof that Covid-19 causes stroke in the absence of comorbidities in a patient.

As per the neurologists, if people with pre-existing conditions like blood pressure, diabetes or any heart related ailments test positive for Covid-19, they should immediately get admitted to the hospital.

Speaking to IANS, P.N. Renjen, Senior Consultant (Neurology) at Delhi's Indraprastha Apollo Hospital, said that coronavirus has been shown to cause development of microthrombi (small clots).

"These clots can travel to the lung and obstruct blood flow to the lung, which is called pulmonary embolism, or travel to brain circulation and cause ischemic stroke. It seems to be happening to those affected with severe Covid symptoms," he said.

Cases have emerged where people with zero comorbidities have had strokes and tested positive for Covid-19.

Renjen added, "While the chances having of a Covid-19 induced stroke are higher in people with pre-existing comorbidities, there is proof that it can also cause stroke in the absence of comorbidities in a patient."

Recently, a 54-year-old woman was treated at the Indraprastha Apollo Hospital after suffering from a stroke and she also tested positive for Cvodi-19. She had no history of blood pressure or diabetes, and also had no complaint of any visible symptoms of Covid-19 like fever or breathlessness.
 

Neelesh Gupta, Consultant Neurologist at Nayati Medicity, Mathura, said, "Neurological symptoms are seen in around one-third of Covid-19 patients of which stroke (haemorrhagic more than ischemic), anorexia, headache and neuropathy (GBS) are common. The reason is that coronavirus has high affinity to ACE 2 receptors which are present in brain cells that lead to neurological symptoms on Covid-19 patients."

Bhushan Nilkanth Joshi, Consultant Neurologist at the Columbia Asia hospital in Pune, agreed that there is proof that Covid-19 causes stroke even in the absence of comorbidities in a patient.

"Covid basically leads to a hypercoagulable state which leads to stroke. Hence now-a-days a lot of patients are suffering from stroke as the most common neurological presentation," added Joshi.

Praveen Gupta, Director, Neurology, Fortis Memorial Research Institute, Gurugram, said, "We have had two or three Covid-19 patients having issues with heart rhythm. Brain haemorrhage generally occurs in the elderly, and we have had patients who developed stroke on admission.

"Lung injury is due to clotting. A clot in the brain causes stroke and a clot in the heart causes heart diseases. It is observed that people who have existing risk factors, such as high blood pressure and diabetes, are not checking them regularly."

He added that in the backdrop of the Covid-19 pandemic, people having symptoms of stroke should rush to the hospital.

On the other hand, A.K. Sahani, Chief of Neurology, Indian Spinal Injuries Centre, Delhi, said it is a hypothesis that Covid-19 is causing stroke in the absence of comorbidity, and there is no evidence whether it is an association or a causal factor.

"Covid-19 can cause hemorrhagic stroke, ischemic stroke and impaired blood circulation to the brain. The virus can also cause a hypercoagulant state that can cause stroke. The studies which have attempted to establish Covid-19 as an independent factor for stroke have clearly stated that more patients should undergo more aggressive monitoring," said Sahani.