COVID-19 Linked to Large Vessel Stroke in Young Adults

Physicians in New York City, which still leads the nation in reported COVID-19 cases, are reporting significantly more acute, large vessel strokes in young adults infected with COVID-19.

In a rapid communication to be published online April 29 in the New England Journal of Medicine, investigators led by Thomas Oxley, MD, PhD, department of neurosurgery, Mount Sinai Health System, report five cases of large vessel stroke over a 2-week period in COVID-19 patients under age 50 years. This represents a sevenfold increase in what would normally be expected.

The five cases had either no, or mild, COVID-19 symptoms.

The message for neurologists and other physicians is that we're learning that this can disproportionally affect large vessels more than small vessels in terms of presentation of stroke.

Inflammation in the blood vessel walls may be driving thrombosis formation.

Recently, investigators in the Netherlands found a remarkably high 31% rate of thrombotic complications among 184 critical care patients with COVID-19 pneumonia.