The Link Between COVID-19 and Large-Vessel Strokes

3 min read  |  May 07, 2021  | 

After more than a year of observing the COVID-19 pandemic, people still have questions about the virus’s effect on the human body. One area of interest is the relationship between COVID-19 and large-vessel strokes. As researchers learn more about this topic, the risk appears to be more significant than many realize.

Researching the COVID-19 and stroke connection

The potential link between COVID-19 and large-vessel strokes first gained attention early in the pandemic, according to Dileep R. Yavagal, M.D., director of Interventional Neurology at the University of Miami Health System.

In May 2020, researchers at Mount Sinai noted five patients with COVID-19 and large-vessel stroke who were all under 50. The occurrence was unusual since the typical age of people who have strokes range between 65 to 70.

Since then, research in this area has continued. And it seems to strengthen the connection between COVID-19 and large-vessel strokes, the most common form of ischemic stroke. In March 2021, Dr. Yavagal was involved with an international, multicenter study, and the findings were published in the journal Neurosurgery. This study evaluated 6,698 COVID-19 patients admitted to 10 different stroke centers around the world.

What the study uncovered

The rate of large-vessel strokes among patients was much higher than average (close to 60%, compared to the usual 20 to 30%). In addition, stroke patients were much younger than typical, with a median age of 51. Dr. Yavagal says that African American patients were also disproportionately affected, making up 28% of the participants in the study.

More research is needed to determine the connection between COVID-19 and increased stroke risk, Dr. Yavagal says. “This data fits with the increased risk of blood clotting seen in COVID-19 patients, as well as the blockages caused by these clots. Therefore, it’s possible that this clotting caused by COVID-19 is resulting in a higher proportion of large-vessel strokes.”

What is a large-vessel stroke?

According to the American Stroke Association, the two primary types of stroke are:

  • ischemic stroke, where blood flow is blocked to the brain
  • hemorrhagic stroke, where a blood vessel breaks and leaks blood into your brain

Ischemic strokes are by far the most common, accounting for 87% of all strokes.

Large-vessel strokes, the most common form of ischemic stroke, occur when a larger vessel, such as an artery, in the brain is blocked.

Can I reduce my stroke risk?

Time will ultimately tell the story as to whether COVID-19 infection is causing more large-vessel strokes. In the meantime, however, it presents yet another compelling argument for practicing good habits such as wearing masks, socially distancing, and following other strategies for reducing your risk of infection.

In addition, this form of stroke is very treatable if you recognize the signs and seek immediate emergency help, Dr. Yavagal says.

The symptoms to watch out for form the acronym BE FAST:

  • Balance – Sudden loss of balance or coordination
  • Eyes – Sudden blurred vision or loss of vision in one or both eyes
  • Face – Facial weakness or an uneven smile
  • Arms – Weakness and loss of function in one or both arms
  • Speech – Impaired of slurred speech, difficulty repeating simple phrases
  • Time – Call 9-1-1 immediately. A large-vessel stroke is a medical emergency.

Wyatt Myers is a contributing writer for UMiami Health News.

Tags: blood clots, COVID-19, covid-19 in Miami, neurology care in Miami, Stefan Kénel-Pierre, stroke risk

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