Reference: Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. DOI: 10.1056/NEJMc2009787

On April 29, local time, the New England Journal of Medicine published a study reporting on 5 young COVID-19 patients at Mount Sinai Medical Center in New York, USA, who sought medical treatment with stroke ( stroke ) as the first clinical manifestation. cases. The hospital received five COVID-19 patients with stroke as the first manifestation from March 23 to April 7. The patients were all under 50 years old and had mild or no obvious symptoms of infection.

Dr. Thomas Oxley, the first author of the paper and a neurosurgeon at Mount Sinai Medical Center, said that more and more evidence shows that COVID-19 infection may cause abnormalities in the human coagulation system, and increased coagulation in large arteries can lead to a series of serious diseases, such as stroke.

Health Times once reported that Hu Weifeng, deputy chief physician of the urology department of Wuhan Central Hospital , developed symptoms of cerebral hemorrhage after he was diagnosed with new coronavirus pneumonia. The director of the encephalology department of a tertiary hospital in Guangdong, who had gone to Wuhan for first-line support, said that the main consideration for this situation was There is a problem with coagulation function . The liver is the factory that produces coagulation factor . If the liver function is not good, the coagulation factor will be blocked.

Dr. Thomas Oxley believes that due to viral infection, the blood is prone to clots, and these clots may flow with the blood to the brain and block the cerebral arteries. When blood flow stops, brain cells will continue to die. The longer the interruption time, the more severe the damage to the brain.

Dr Thomas Oxley said that in the 12 months last year, the medical center saw an average of 0.73 stroke patients under the age of 50 every two weeks; and in the past two weeks, it saw 5 stroke patients under the age of 50. Patients, the incidence of stroke has increased sevenfold in young COVID-19 patients in the United States, most of whom have no previous medical history and have mild symptoms of infection. The survey found that many patients were unwilling to go to the hospital or call emergency services because of the epidemic, and had no awareness of stroke prevention.

People infected with COVID-19 should not only pay attention to common pneumonia symptoms such as cough, fever, and shortness of breath, but also be alert to signs of stroke. Once stroke symptoms such as face droop, arm weakness, and difficulty speaking appear, call the emergency hotline as soon as possible. (Compiled by Wang Yueming)

Reference: Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. DOI: 10.1056/NEJMc2009787