What’s known about COVID-19 and increased potential for stroke

When it comes to the novel coronavirus and its potential to increase risk for stroke, knowledge is growing and evolving quickly, according to an expert with Johns Hopkins Medicine in Baltimore.

“What we know about this is changing on a weekly basis, both because the virus is changing in some ways, but also because more literature is coming out and more people are studying stroke in coronavirus patients,” said Rebecca Gottesman, professor of neurology and epidemiology at Johns Hopkins.

Gottesman said there does appear to be increased risk of stroke for COVID-19 patients. Between about 1% and 6% of patients who go to the hospital or emergency room with the illness have strokes.

“That doesn’t mean that’s their presenting symptom of COVID — they had COVID-like symptoms and then they’re found to have a stroke at some point,” Gottesman said.

Potential explanations for the increase in stroke cases in COVID-19 patients:

  • Increased clotting occurs in the veins and arteries of COVID-19 patients, more so than in patients with other conditions and infections.
  • A lot of COVID-19 patients already have heart problems, and the virus can cause weakened, less effective heart pumping that can lead clots to form in the heart, which then migrate into the brain to cause strokes.
  • In general, people have some higher risk of stroke in the months after recovering from infections such as influenza — perhaps because of inflammation in the body from trying to fight the infection. “That risk is certainly still there for coronavirus, probably even more so than it was for influenza,” Gottesman said.

Studies now underway involve the use of blood thinners to address and treat stroke risk in COVID-19 patients.

“We need to understand more about the best way to treat people with COVID to reduce that little bit of extra risk of stroke we see,” Gottesman said.


More Coronavirus News

Looking for more information? D.C., Maryland and Virginia are each releasing more data every day. Visit their official sites here: Virginia | Maryland | D.C.


Gottesman said concern about contracting the coronavirus in the emergency room or hospital should not prevent you from getting evaluated, diagnosed or treated for cardiac or stroke-related conditions.

“Don’t ignore strokelike symptoms, regardless if you have COVID or not,” Gottesman said. “If you’re someone who’s experiencing weakness, numbness, difficulty speaking, difficulty seeing, extreme dizziness — any of those symptoms — get yourself to the hospital.”

Do not have someone drive you to the hospital; call an ambulance.

“The ambulance gets you there faster and gives pre-warning to the emergency room that you’re coming to get the right team in place,” Gottesman said.

An ambulance also may take you to a certified stroke center best able to evaluate and treat the condition.

Also, every minute counts when it comes to the ability to use clot-busting medicine that can’t be administered to people seeking help too late.

To help you remember warning signs of stroke, think “FAST”:

  • F — face drooping
  • A — arm weakness
  • S — speech problems expressing or understanding words
  • T — time to call 911.

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