Are COVID Patients Susceptible to other infections?

Clipo
4 min readJul 10, 2020

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Unfortunately, the answer to the above statement is apparently YES, based on recent research.

Top in Trends: Medical News

The recent study published in “JAMA Neurology” suggests that COVID is not only affecting the people alone and is also making them susceptible to other diseases as well.

Review: Risk of Ischemic-Stroke* in Patients with Coronavirus Disease 2019 (COVID-19) vs Patients with Influenza.

(*An ischemic stroke occurs when an artery in the brain becomes blocked.)

The study in the first place was designed to evaluate the hypothesis that COVID patients are more susceptible to getting Ischemic stroke than those who have suffered from other viral infections such as Influenza.

The hypothesis was in the limelight as most of the peer publications suggested the same but none of them was able to confirm it effectively and systematically. And hence the researcher’s team tried to answer the research question.

The study was carried out in 2 hospitals which are based out in New York, Of which one is a quaternary care hospital and the other is an academic community hospital. One section dealt with the laboratory-confirmed cases whereas the other dealt with those who are confirmed to have Influenza A/B during their emergency visits. The first section which includes the patient’s data from admissions for from 4th March 2020 till 2nd May 2020, was compared against the data from those whose details were available from 1 January 2016 to 31st May 2018 from Cornell Acute Stroke Academic Registry (CAESAR), which they had used to ascertain ischemic strokes in the influenza cohort. Electronic data capture was employed for data collection in both cases.

The primary outcome was the acute ischemic stroke. The Covid 19 Cohort was screened for acute ischemic stroke by using CT and MRI, which were reviewed by 2 of the attending neurologists, post their admission during their visit to the department. A third independent neurologist resolved the disagreements between the neurologists. Those who are found to be having a stroke were again studied by 2 neurologists and disagreements were resolved by a third one for the evaluation of etiological Mechanisms.

The Influenza cohort also did employ the same methods as of the Covid19 cohort and the data were retrieved from CAESER. ascertainment of ischemic stroke was based on clinical and imaging data for both cohorts. Study neurologists also tabulated data on the National Institutes of Health stroke scale at the time of stroke diagnosis. This scale ranges from 0 to 42 and higher scores indicate more severe strokes.

The trial was given consent from the review board without needing to provide informed consent as the risk of the study is low risk, and it cannot be performed otherwise.

COVID-19 and Influenza Cohorts comparison:

The 1486 influenza patients were on average, younger compared to the 1916 COVID-19 patients; more frequently, women; less often had hypertension, diabetes, coronary artery disease, chronic kidney disease, or atrial fibrillation; and more frequently had hyperlipidemia**. Influenza patients also became less likely to be admitted to an ICU or undergo mechanical care Ventilation and lower sedimentation rates for D-dimers and erythrocytes.

(**Hyperlipidemia is a term used to describe high levels of fat in the blood, such as cholesterol and triglycerides.)

In an unadjusted study, patients with COVID-19 were more likely than patients with influenza to experience an acute ischemic. Upon adjustment for age, sex, and race, our findings were identical.

The correlation between COVID-19 and acute ischemic stroke has persisted across several sensitivity analyses.

Discussion:

The incidence of acute ischemic stroke was higher than the rate of influenza-infected patients who visited or were hospitalized. The results were consistent through multiple sensitivity analyses, including analyses adapted to the number of vascular risk factors and ICU admission status, a replacement for disease severity. They also found that Sars cov affected patients with an ischemic stroke are far more likely to die than patients with an ischemic stroke without Covid 19 infection.

Variation:

There were many variations in the hypothesis as our understanding of neurological effects off Sars cov affected patients is limited as of now.

Example:

For the 214 patients in Wuhan, China, who got Covid 19, 3 percent had a stroke. Among 13 Covid 19 patients who had brain MRI in France, 23 percent had an ischemic stroke.

Conclusion:

The proportion of Emergency department visited patients and Covid 19 hospitalizations with acute ischemic stroke were higher than that of patients who visited the Emergency Department or underwent influenza hospitalizations. These findings suggest that clinicians should be alert to symptoms and signs of acute ischemic stroke in Covid 19 patients to implement time-sensitive procedures, such as thrombolysis and thrombectomy, to reduce the long-term disability burden, if possible. At the same time, more explanation on Thrombotic pathways can produce improved strategies to avoid impaired thrombotic complications such as ischemic stroke in patients with Covid 19.Keep checking on us for more curated and handpicked science and health articles.

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References:

Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza

Image Credits are with respective owners and the images were taken from Google for representation.

By,

Gopala Krishna Varshith,

Content Developer and Editor,

CLIPO.

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