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This Can Be the First Sign of COVID, Study Finds

Your very first sign of trouble could be devastating.

The very first indication a young person has COVID-19 can be a particularly devastating symptom: A stroke.

That's the result of a study recently published in the journal Neurology. Researchers analyzed 10 studies involving 160 patients who'd suffered a stroke along with COVID-19; they found that half of the patients under age 50 had no other symptoms before their stroke occurred. Read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.

COVID isn't just a lung disease

"One of the most eye-opening findings of this study is that for patients under 50 years old, many were totally asymptomatic when they had a stroke related to COVID-19, [which] means that, for these patients, the stroke was their first symptom of the disease," said the study's lead author Dr. Luciano Sposato, an associate professor and chair in stroke research at Western University in Ontario, Canada.

When COVID-19 surfaced globally more than eight months ago, medical experts considered it primarily a respiratory illness. Today, following months of reports of COVID patients suffering blood clots, pulmonary embolisms and strokes, they say it might also be a vascular one—meaning, affecting the blood vessels.

"In early April of 2020, we realized that COVID-19 was a highly thrombogenic [clot-forming] disease," Sposato told Medscape this week. That led him and his colleagues to undertake the study.

The study found that 43% of COVID-19 patients under age 50 had no previous risk factors for stroke. And 48% of those patients had a stroke before they experienced any COVID-19 respiratory symptoms.

"We should consider COVID-19 as a new cause or risk factor for stroke. At least, patients with stroke should probably be tested for SARS-CoV-2 infection if they are young and present with a large vessel occlusion, even in the absence of typical COVID-19 respiratory symptoms," Sposato told Medscape.

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Why does this happen?

The researchers speculate that the blood clotting leading to stroke could be caused by the "exaggerated inflammatory response" provoked by the novel coronavirus. 

COVID-19 seems to cause widespread inflammation throughout the body, including in the brain, lungs, heart and blood vessels. In severe cases this can be fatal, causing stroke or respiratory failure. Even in minor cases of the disease, researchers believe this inflammation can lead to fatigue, muscle problems and neurological problems that can last for weeks or months. 

"Infections and inflammation increase the risk of stroke," wrote Dr. Babak Navi, medical director of the Weill Cornell Stroke Center, on the hospital's website on Aug. 26. "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. 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." 

According to the CDC, signs of stroke include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body; sudden confusion, trouble speaking, or difficulty understanding speech; sudden vision trouble; or sudden difficulty walking, dizziness, loss of balance, or lack of coordination. If you experience any of these symptoms, seek medical help immediately.

And do everything you can to prevent getting—and spreading—COVID-19 in the first place: Wear a face mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.

Michael Martin
Michael Martin is a New York City-based writer and editor. Read more about Michael