PATIENTS in Scotland will be among those tracked as part of a world-first study evaluating the impact of Covid on stroke patients.
Clinicians want to establish whether the disease causes more serious and long-lasting disability, and what makes some stroke victims with the infection at risk of poorer outcomes.
The study, funded by the Stroke Association, will follow 4000 stroke survivors with and without positive Covid tests from 13 UK emergency units, including the Queen Elizabeth University Hospital in Glasgow.
Their rehabilitation and health will be monitored through brain scans, blood samples and measures of disability. The findings will shed light on how Covid impacts stroke recovery and help guide approaches to treatment.
Since the beginning of the pandemic, medics have noticed strange symptom patterns and unusually prolonged illness in some patients presenting with strokes.
Dr Terry Quinn, a consultant in stroke medicine at the QEUH, said: “People were coming into hospital with strokes at a younger age than we would normally see.
"The patterns of the damage and the symptoms of the stroke were different. When we did tests, the test results were different, and it was all in the patients who had Covid.
“A stroke is usually caused by a blood clot in a blood vessel, but the people who had Covid had blood clots in multiple vessels, which is really quite unusual.”
Stroke specialists across the UK, including Dr Quinn, pooled patient data and found that it was “very clear” that some stroke patients with Covid were developing atypical symptoms such as larger blood clots, multiple clots, or blood clots in unusual regions of the brain, and were suffering a more severe stroke as a result.
Some older patients who had a strokes associated with Covid experienced “really severe delirium” - a state of extreme drowsiness and confusion - and would be bedridden for a long time, leading to rapid muscle wastage.
“Trying to rehabilitate them and get them back on their feet was a real effort,” said Dr Quinn.
The research to date has led to a change in treatment protocols, such as routine testing of stroke patients for Covid and slightly different uses of blood thinning drugs. The infection is known to make blood sticky and more prone to clotting.
However, Dr Quinn - a clinical lecturer at Glasgow University who is taking part in the Stroke Association study - said there remain “unanswered questions” about what happens to most patients long-term.
“Anecdotally, people I’m seeing in my clinics who have had Covid and stroke are telling me they’re having major problems with memory, with thinking, with their energy levels,” he said.
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“We would sometimes see [these symptoms] but they seem to be even more of an issue in people who’ve had a stroke associated with Covid.
“But we need to be careful of taking a couple of cases and an anecdote and assuming there’s something real happening.
“The vast majority of people who have Covid don’t have these symptoms, and I’ve seen a lot of people who’ve had a stroke and had Covid who haven’t had a really major stroke - who haven’t had unusual patterns of blood clotting. That’s an important message.
“But I’ve seen enough that I’m worried about it.”
More than 20,500 people have died from strokes or heart disease in Scotland since the beginning of 2020.There are more than 128,000 stroke survivors in Scotland and forecast to be 173,000 by 2035.
The pandemic “shattered” fundraising efforts, however, and the Stroke Association has had to halve its research budget.
Dr Quinn said stroke medicine faces a “perfect storm” in the months and years ahead.
He said: “We’ve got a new condition, but our clinicians are knackered - they’ve been through a lot - and at the same time, the funds available to support research have been decimated.”
READ MORE: Firefighter still recovering year after two strokes triggered by Covid-19
Dr Rubina Ahmed, research director at the Stroke Association, said: “It’s extremely concerning that we’re seeing strokes happening in ways we have not seen before.
“This research is absolutely critical in understanding and treating stroke after Covid-19, to help reduce the devastating effects and ultimately improve lives."
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