Adult patients with asymptomatic COVID-19 face a heightened risk of acute ischemic stroke (AIS) well after the infection, according to a new study published in JAMA Network Open.
Researchers identified 18 patients treated for AIS at public hospitals in Singapore from May 21 to Oct. 14, 2020. All patients had confirmed asymptomatic COVID-19 infections. They were all men and came from South Asian countries. The median patient age was 41 years old
After reviewing each patient’s electronic medical records, the authors found that the median time from a positive serological test result to AIS was 54.5 days. The median National Institutes of Health Stroke Scale score, meanwhile, was five.
While 10 patients presented with a large vessel occlusion, six had to undergo intravenous thrombolysis or endovascular therapy. Overall, the annual incidence rate for AIS was 82.6 cases per 100,000 people; that’s much higher than the 38.2 cases of AIS per 100,000 people observed in a matched cohort.
“Given the paucity of risk factors for stroke apart from the presence of SARS-CoV-2 antibodies, AIS could be part of the next wave of complications in the COVID-19 pandemic,” wrote lead author Tian Ming Tu, MRCP, a neurologist at the National Neuroscience Institute in Singapore, and colleagues. “Stroke units should be on high alert and administer serological testing, especially in younger adults or in the absence of traditional risk factors.”
At this stage, however, the team did say it was “debatable” that serological COVID-19 screening was needed—or that it would provide much clarity if it was implemented.
“Even if patients with asymptomatic COVID-19 infection were identified using serological tests, we may still be unable to ascertain the therapeutic implications for thrombotic events in these patients,” they wrote. “The recent halting of recruitment for three trials of critically ill patients with COVID-19 because of lack of improved outcomes only demonstrates the lack of evidence for anticoagulation in COVID-19.”
Click here to read the full analysis in JAMA Network Open.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.