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The Stroke/COVID-19 Connection

Posted by By Marissa Oller-Cramsie, DO
Board-certified Neurologist
Holy Name Medical Partners on May 24, 2020

Marissa Oller-Cramsie, DO, Board-certified Neurologist Holy Name Medical Center

COVID-19 is thought of as primarily a respiratory illness that places the elderly and those with underlying conditions at greatest risk. But mounting clinical evidence shows that it can affect the whole body and undermine other organ systems – from cardiovascular to neurological – even in younger people.

Among other things, the disease caused by this novel coronavirus can increase the risk of blood clots and stroke, even in otherwise healthy young and middle-aged adults. Signs of stroke or other neurological impairment, such as weakness or confusion, should not be ignored.

Be Alert to These Signs

One of the first signs of the virus, in fact, is neurological as a number of victims reported that they lost their taste and smell before the onset of more serious symptoms. Most cases of COVID-19 are mild, but when it hits hard things can become serious suddenly.

Some patients with COVID-19 have been exhibiting hyper-coagulation, meaning their blood has thickened and the blood vessels are inflamed. Because of this, even those with what are considered milder cases can be more prone to blood clots. Those clots can travel to the lungs and the brain, where they cause large-vessel strokes.

This disease is new, and we are learning and adapting in addressing some of the heretofore unpredictable presentations of COVID-19. We draw on the best practices of other medical situations, such as using blood thinners to treat stroke. But as doctors on the front lines of this pandemic we have to be disease detectives as there is little confirmed science about some aspects of COVID-19.

The Onset of Neurological Conditions

Pulmonologists and other medical doctors were overwhelmed in the first crush of cases. Then we began to see the neurological complications: strokes, encephalitis (inflammation of the brain) and even Guillain-Barré syndrome, a relatively rare nerve disorder that can lead to paralysis. We saw two cases of the latter at Holy Name even before there was medical literature on the phenomenon related to coronavirus.

We're vigilant in looking for neurological complications, not assuming that confusion, for instance, is solely the result of fever and infection. Patients should not hesitate to come to the Emergency Department if they have stroke symptoms.

Think of the acronym FAST:

  • Face drooping
  • Arm or leg weakness
  • Speech difficulties
  • Time to call 911

Safe and Clean

Thankfully, the incidence of COVID-19 seems to be on the decline in northern New Jersey. In early May, Holy Name was the first hospital in North Jersey to complete a rigorous, deep cleaning of our 450,000 square feet of clinical and non- clinical space. We started with manual disinfection, then applied electrostatic sanitizing mist, and finally, blasted UV-C light to kill more than 30 types of pathogens—including COVID-19.

It has been challenging and healthcare providers have been on a rapid learning curve as this new disease swept through the region. Scientists and clinicians continue to grapple with understanding COVID-19 and how it is best treated.

Researchers worldwide are studying coronavirus and looking for patterns, antidotes and effective therapies for COVID-19. The science is emerging. We’re fortunate at Holy Name to be participating in a number of clinical trials aimed at finding the best treatments for this insidious disease.

In the meantime, do not ignore any stroke symptoms and don’t hesitate to seek treatment at Holy Name’s Emergency Department.

Marissa Oller-Cramsie, DO, is a board-certified neurologist with a special interest in neurophysiology. Her office in Teaneck is currently offering in-person and telemedicine appointments by calling
201-833-7208 or visiting northjerseytelemedicine.com.