Severe strokes & COVID-19: What’s the link?

Seamus Daley-Dee

Marketing Executive, Neuro Convention

Stroke Awareness Month took place during May and this year’s campaign focused on raising awareness of the damaging effects of the COVID-19 pandemic on stroke research. Now, a report from the COVID-19 Stroke Study Group has found an association between COVID-19 and more severe strokes, as well as strokes in younger people.

Widespread increase in stroke throughout the pandemic

Led by a team of Geisinger researchers, the report focused on a group of 432 patients diagnosed with COVID-19 and who had experienced strokes from 17 countries. Among this group, the study found a significantly higher incidence of large vessel occlusion (LVO)– strokes caused by a blockage in one of the brain’s major arteries that are typically associated with more severe symptoms. Nearly 45% of strokes in the study group were LVOs, which was notable as in the general population, just 24-38% of ischemic strokes are LVOs.

It also found that more than a third of people in the group were younger than 55, and nearly half were younger than 65. Pre-pandemic general population data showed 13% of strokes occurred in people under 55, and 21% in people younger than 65.

The data showed that less severe strokes, mostly in critically ill patients or overwhelmed health centres, were underdiagnosed. Researchers determined this finding significant because a minor or less severe stroke may be an important risk factor for a more severe stroke in the future.

Ramin Zand MD, a vascular neurologist and clinician scientist at Geisinger and leader of the study group, said: “Our observation of a higher median stroke severity in countries with lower healthcare spending may reflect a lower capacity for the diagnosis of mild stroke in patients during the pandemic, but this may also indicate that patients with mild stroke symptoms refused to present to the hospitals.”

A minor or less severe stroke may be an important risk factor for a more severe stroke in the future.

COVID-19 Stroke Study Group

Throughout the pandemic, people with COVID-19 have reported symptoms involving the nervous system, ranging from a loss of smell or taste to more severe and life-threatening conditions such as altered mental state, meningitis and stroke. A group of Geisinger scientists and a team of experts from around the world formed the COVID-19 Stroke Study Group shortly after the pandemic began to study the correlation between COVID-19 infection and stroke risk.

Results from the first phase of the study, which included data on 26,175 patients, indicated an overall stroke risk of 0.5% to 1.2% among hospitalised patients with COVID-19 infection. The finding demonstrated that, even though there were increasing reports of patients with COVID-19 experiencing stroke, the overall risk is low.

“Our initial data showed that the overall incidence of stroke was low among patients with COVID-19, and while that hasn’t changed, this new data shows that there are certain groups of patients — for example, younger patients — who are more affected,” said Vida Abedi, Ph.D., a scientist in the department of molecular and functional genomics at Geisinger. “We hope these findings highlight new research directions to better identify patients at risk and help improve the quality of care.”

Geisinger has an exciting research environment with more than 50 full-time research faculty and more than 30 clinician scientists. Areas of expertise include precision health, genomics, informatics, data science, implementation science, outcomes research, health services research, bioethics and clinical trials.

The research has been published in the journal. Stroke.