COVID causes stroke?

Some of the largest medical centers in the Northeast are reporting a new phenomenon: COVID-19 patients dying of strokes.

Mount Sinai Hospital in New York City recently published a case report in *The New England Journal of Medicine *documenting a handful of COVID-19 patients experiencing new-onset symptoms of large-vessel ischemic stroke, the most deadly kind.

Approximately 5% of all hospitalized patients in Wuhan, China, the global pandemic's suspected origin site, displayed "incidence of stroke," according to a retrospective study cited in *The Journal *report.

Typically, more than 70% of all strokes occur over the age of 65.

Mohamad Chmayssani, MD, a neurologist with Baptist Lyerly Neurosurgery said a number of factors can contribute to the formation of blood clots, a leading cause of stroke.

"In general, when someone gets an infection which could be anything from a simple urinary tract infection to full-blown pneumonia, the blood becomes thicker and prone to forming clots," said Dr. Chmayssani, who specializes in neurocritical care at Baptist Medical Center Jacksonville.

"With COVID-19 patients, doctors have noticed that the propensity for forming clots is out of proportion to what other diseases have shown. A lot of these clots are primarily impacting the lungs and kidneys."

While Baptist Medical Center Jacksonville has not any cases of COVID-19 patients presenting with stroke, according to Dr. Chmayssani, the medical center has instituted a new protocol when treating symptomatic patients. "When these patients are admitted, we measure certain blood markers and if the markers are high enough, we start the patient on potent blood thinners to prevent clots from forming," he said.

Researchers at the Massachusetts Institute of Technology and the University of Colorado Denver are looking into the repurposing of tissue plasminogen activator (tPA) for use in COVID-19 patients. Their findings were recently published in The Journal of Trauma and Acute Care Surgery.

tPA is the only FDA-approved treatment for a stroke caused by a blood clot and has been routinely used in treating life-threatening heart attacks and lung clots, Dr. Chmayssani said.

At Baptist Health, we want to help keep our community informed about COVID-19. For more information, visit baptistjax.com/covid19. Baptist Health physicians are here for you during this time and can diagnose, treat and prescribe medications virtually. Request an online doctor appointment here.