What to Know about Stroke and COVID-19

A stroke is a sudden interruption of the blood supply to the brain, depriving the brain of oxygen and nutrients. This is a complex occurrence with many causes and symptoms. Fast treatment is crucial because it prevents death and long-term damage. 

During the COVID-19 pandemic, there has been an increase in the number of strokes. Unfortunately, fewer patients are seeking immediate help due to fear of the new virus. Those who suffered a stroke before the pandemic may be experiencing heightened anxiety.  

Dr. Babak Navi, Associate Professor of Neurology and Neuroscience at Weill Cornell Medicine and Medical Director of the Weill Cornell Stroke Center, explained the complex connection between stroke and COVID-19—and emphasized that patients seek care immediately if they believe they have suffered a stroke.  

The link between stroke and COVID-19 

At the onset of COVID-19, it was believed that the virus affected the lungs. Now, however, physicians have seen several patients who have been impacted in other ways, including damage to the kidneys and other organs 

Since the COVID-19 outbreak, there has been an increase in strokes among young and middle-aged people who have contracted COVID-19. The data is limited, given how new the disease is, but the connection is there.  

 “I believe there is a link, which needs to be confirmed in large, high-quality studies,” explained Dr. Navi. “I suspect the association is driven by multiple factors. First, infections and inflammation increase the risk of stroke. COVID-19 is an infection that produces a strong inflammatory reaction from the body. Second, COVID-19 seems to trigger cardiac events: heart attack, dangerous heart rhythms, etc. All of these factors can lead to a stroke. Third, COVID-19 causes a severe critical illness, which can lead to multi-organ failure, including kidney failure. Being critically ill and having multiple organs fail can place patients at a higher risk for stroke. The last potential explanation is how COVID-19 affects the body’s clotting system. It seems to promote clot formation, as evidenced by laboratory studies, but we don’t know exactly how.”  

Dr. Navi also asserted that patients should look at the bigger picture. “I want to caution people that they shouldn’t overreact,” he detailed. “Most people who contract COVID-19 do not develop stroke and have only a mild illness. We need better data before we can conclude that COVID-19 is a strong risk factor for stroke.”  

Do not ignore stroke symptoms out of fear 

If you or someone you know think they might be having a stroke, call 911 and go to a hospital to get treated.  

Remember, a stroke is a medical emergency. Fast treatment prevents death, long-term damage, as well as reduces the risk of a second stroke. The most effective treatment happens within a few hours after the stroke occurs. 

“People who are having strokes are not seeking the treatment they need. This is a very big issue,” warned Dr. Navi. “The fear of contracting COVID-19 should be put into context of not receiving potentially life-saving treatment or appropriate strategies to prevent more strokes and brain injury.”  

“There is a strong correlation between the time from stroke onset to the time when acute stroke treatments are administered and their effectiveness,” asserted Dr. Navi.  

It is understandable to be afraid or reluctant to go to the emergency department during the COVID-19 pandemic. However, a stroke is highly dangerous and requires immediate attention. At Weill Cornell Medicine, our healthcare providers are doing everything possible to protect patients from the virus and provide crucial medical help to those who need it.  

Dr. Navi emphasized that it is safe for patients who suspect that they have had a stroke to come to Weill Cornell Medicine for care. “There are extreme measures taken to reduce the transmission of COVID-19,” he reassured. “Patients with COVID are separated from patients without COVID. Healthcare workers are wearing PPE. Things like handshaking don’t really happen anymore. Any direct contact with patients is limited to when it’s really necessary. In New York, at least, the number of new COVID-19 cases has dropped precipitously.”  

Use the FAST method to assess any potential symptoms in yourself or your loved ones:  

  • Facial drooping 
  • Arm weakness 
  • Speech difficulties 
  • Time to call 911 

Recommendations for stroke survivors during the COVID-19 pandemic  

Experiencing a stroke is terrifying, and now stroke survivors are facing a global pandemic. Thankfully, some of the same tools that you used to face your recovery can now be used to deal with the trauma of COVID-19. 

“Unfortunately,” said Dr. Navi, “a stroke survivor is on average more likely to develop serious illness from COVID-19. They often have high blood pressure, diabetes, and other conditions that increase the probability that if they develop COVID-19, it would be a more severe form.” 

Infection prevention is critical 

We know that patients with heart disease and high blood pressure, as well as the elderly, are at higher risk of COVID-19 complications. Stroke survivors are also at a higher risk of contracting and developing severe symptoms of COVID-19. 

Therefore, it is even more critical for stroke survivors to take precautions from contracting the virus than those at lesser risk. Wash your hands often with soap and water and limit going out of your home to only essential needs. Avoid unnecessary interaction with other people who may be exposed. 

It’s important to keep in mind that, although there is an increased risk for stroke survivors, most people will recover well if they do become infected. 

Maintain physical health 

Keep your healthcare appointments, if possible. Physical therapy, speech therapy, and occupational therapy are essential to your stroke recovery. Access to direct care within your clinic’s safe environment will help you maintain long-term health. 

Although social distancing requirements may affect these appointments, do not neglect them. If you have an upcoming scheduled appointment and have not been contacted by your provider’s scheduling office, please call to confirm, or make any changes that you may need. You may be able to use telehealth for some follow-up appointments. 

Continue to stay physically and intellectually active. Moving our bodies helps us clear our minds and eliminate tension. Alternating physical activity with reading or puzzles can help regulate our bodies and keep anxiety in check. 

Maintain emotional health 

As with all of us facing concerns about COVID-19, coping mechanisms can help stroke survivors manage difficult emotions and better support emotional well-being. 

Stick to your regular schedules and routines as much as possible. When you cannot do so, develop new ones that you and members of your household can follow for the duration of the crisis. In a time of such intense uncertainty, routines and schedules provide certainty and stability. 

Maintain other healthy habits, such as eating regularly, sticking to a healthy diet, and getting a good night’s sleep. 

Reach out often to friends, family, and support groups. Social interaction and emotional support can make a big difference in alleviating some of the anxiety. 

Video visits for stroke survivors  

At Weill Cornell Medicine, stroke survivors can meet with a neurologist virtually for care. The video visit service is available to new patients, as well as existing patients.  

“We’ve gone to nearly one hundred percent video visits,” explained Dr. Navi. “Stroke survivors can discuss their specific conditions and receive appropriate tests and treatments. I’ve been able to effectively guide patients, and the same goes for my colleagues.”  

“I encourage stroke survivors who want a second opinion or a neurologist consultation to reach out and schedule a video visit appointment,” he concluded. 

All of us at Weill Cornell Medicine understand that this is a difficult time for all New Yorkers. As experts in immunology, pulmonary medicine, and critical care medicine, we are working diligently to provide the greatest possible care to patients in need. 

We are available to all New Yorkers who have questions or concerns. Please call our hotline at (646) 697-4000 for information about COVID-19 or read our patient guide. 

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