Covid-19 and Venous Stroke: Everything you need to know

By Dr Prashant Makhiji,

Covid-19 disease caused by SARS CoV-2 is primarily a disease of lungs but it is being increasingly recognised to affect other organ systems as well; neurological complications are often being reported in association with Covid-19 around the world. Stroke is one such complication which is reported to occur in association with Covid-19 and is associated with higher morbidity and mortality.

Stroke is a disorder which results from interruption of blood supply to the brain, more often due to clot formation and less commonly due to rupture of blood vessels supplying the brain. Majority of the strokes affect arteries i.e. blood vessels carrying blood which has been filtered by lungs and is rich in oxygen. However, rarely it may involve veins or venous sinuses that carry blood away from the brain, resulting in venous stroke.

Cerebral venous sinus thrombosis (CVT) which results in venous stroke is an extremely rare but serious disorder with an estimated annual incidence of 5 in one million. In contrast to the usual arterial stroke, patients with venous stroke are often young (mean age 33yrs) and is about three times more common in females. Important risk factors for CVT are consumption of certain oral contraceptives, genetic conditions which increase tendency to clot formation, pregnancy, infections and malignancy. Common presentations of CVT include sudden loss of consciousness, seizures and recent onset or worsening headaches.

Covid-19 infection because of its tendency to affect lining of blood vessels(endothelium) and the inflammatory response which accompanies the infection predisposes to clot formation in blood vessels and has emerged as an important risk factor for CVT.

Although a serious disorder with devastating consequences, is very much treatable if recognised in time. Treatment involves administration of blood thinners (anticoagulants) under the supervision of a Neurologist. As dehydration is a common precipitant of CVT in predisposed patients, it is important to maintain hydration in patients suffering from or recovering from Covid-19. It is also important to be aware of its symptoms; in patients with Covid-19 or those recovering from it, if they have any of the above reported symptoms, they should seek urgent consultation from a Neurologist so that timely treatment is initiated and the death and disability associated with it can be averted.

(The author is Neurologist, Wockhardt Hospital, Mumbai Central. The article is for informational purposes only. Please consult health experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)