Why do young coronavirus patients die from stroke?

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An upsurge of reported cases of young, healthy coronavirus patients with stroke has raised fears that the deadly disease will cause blood clots in the brain.

Doctors at hospitals in New York and Philidelphia say they have “never seen so many young people” with obstruction from large vessels, the deadliest type of stroke.

A study in 15 medical centers over a three-week period found that 40% of OVL admissions were from COVID-19 patients under the age of 50 – the average age of severe stroke is 74.

Separate research, not yet peer reviewed, has examined 214 COVID-19 patients treated at three hospitals in Wuhan, China. He found that 36% of patients had neurological symptoms such as altered consciousness or blood clots in the brain.

Once thought to be a disease that mainly attacks the lungs, doctors are now beginning to believe that many deaths from coronaviruses are caused by blood clots.

Clots that start in the lower body can migrate to the lungs, causing a deadly blockage called pulmonary embolism – a common killer in patients with COVID-19.

Blockages near the heart can lead to a heart attack, another common cause of death in infected people. And clots above the chest can cause strokes.

Scientists do not know why the virus causes clots – some say it could be the result of an excessive immune response called a “cytokine storm”.

Others believe that the unique form of COVID-19 helps to cling to blood vessels when it invades the body, damaging them and causing leaks.

Dr Dong Tian, ​​anesthesiologist, was pronounced dead in a Hubei hospital on Saturday morning, a week before his 30th birthday.

Photo shows Dr. Dong performing surgery with colleagues

29-year-old Chinese anesthesiologist Dr. Dong Tian (left) died in March of a stroke after a 35-day battle with the coronavirus. Dr. Dong operating with colleagues (right) before falling ill himself

Once thought to be a disease that primarily attacks the lungs, doctors are now beginning to believe that deaths from coronaviruses are caused by blood clotting. Pictured: body bags of COVID-19 victims at the Maryland Cremation Services in Millersville

Once thought to be a disease that primarily attacks the lungs, doctors are now beginning to believe that deaths from coronaviruses are caused by blood clotting. Pictured: body bags of COVID-19 victims at the Maryland Cremation Services in Millersville

Cytokines are chemical signaling molecules that guide a healthy immune response. They tell immune cells to attack viral molecules in the body.

But in some patients, this process becomes overloaded and the immune cells begin to destroy healthy tissue, known as the cytokine storm.

According to Dr. Jamie Garfield of Temple University Hospital in Philadelphia, this can cause damaged blood vessels to leak and drop blood pressure, which increases the risk of clots.

Dr. Garfield, a pulmonologist who cares for a COVID-19 patient, told Science Magazine that it was “probably” the real reason for many deaths from coronaviruses.

Other scientists say the increase in stroke may be a by-product of the way COVID-19 invades the human body.

HOW CAN COVID-19 LEAD TO A STROKE?

The coronavirus appears to cause blood clotting, which can lead to fatal strokes.

Although experts do not know why the virus causes blockages, there are three main theories:

CYTOKINE STORM

Some say it could be the result of an excessive immune response known as a “cytokine storm.”

Cytokines are chemical signaling molecules that guide a healthy immune response.

They tell immune cells to attack viral molecules in the body.

But in some people, this resonance goes into the overdrive and the immune cells also begin to attack healthy tissue, known as the cytokine storm.

When the blood vessels are damaged, they can leak, causing a drop in blood pressure and increasing the risk of clots.

INFECTION BY-PRODUCT

Other scientists say the increase in stroke may be a by-product of the way COVID-19 invades the human body.

Professor Ian Jones, a virologist at the University of Reading, told MailOnline: “Covid binds to an enzyme called ACE2 which is found on the surface of the cell.

“It just uses it as a way to attach itself, but in doing so, the enzyme function of ACE2 is reduced.

“The consequence is an imbalance of the hormones called angiotensin I and angiotensin II which together regulate blood pressure.

“It could be linked to the increase in reported strokes. “

UNIQUE FORM OF VIRUS

Dr. Robert Bonow, a professor of cardiology at Northwestern University, said it may be the unique form of the coronavirus that causes blood clotting problems.

He said that the tips of the virus, which lock onto cell receptors, can also attach to blood vessels.

Once they are anchored to these cells in the blood vessels, the viral particles can cause damage to them as well as to the heart muscle, says Dr. Bonow.

Professor Ian Jones, a virologist at the University of Reading, told MailOnline: “Covid binds to an enzyme called ACE2 which is found on the surface of the cell. It just uses it as a means of fixing itself, but in doing so, the enzymatic function of ACE2 is reduced.

“The consequence is an imbalance of the hormones called angiotensin I and angiotensin II which together regulate blood pressure. This could be linked to the increase in reported strokes. “

Dr. Robert Bonow, a professor of cardiology at Northwestern University, said it may be the unique form of the coronavirus that causes blood clotting problems.

He told MailOnline: “With COVID in particular, what you see that you don’t have with the flu is because under the microscope, all the peaks of the coronavirus come out, and these peaks are little proteins looking for receptors on the cells they attach to, ‘

“It specifically searches for receptors in the lungs, but these same receptors sit on the blood vessels, so it can attach to the lungs as well as to the blood vessels.”

Once they are anchored to these cells in the blood vessels, the viral particles can cause damage to them as well as to the heart muscle, says Dr. Bonow.

They can trigger “hypercoagual states”, causing blood clots that lead to heart attacks.

If COVID-19 targets blood vessels, this could explain why people who already have damaged vessels – such as diabetes and high blood pressure – are more likely to get seriously ill.

The exact way the virus attacks blood vessels remains a mystery, but several scientific articles and preprints have shown that the deadly side effect is common.

Heart damage was discovered in 20% of patients hospitalized in Wuhan according to a March 25 article in JAMA Cardiology.

Another study in the epicenter of the epidemic found that 44% of people in intensive care had heart arrhythmias.

Thirty-eight percent of Dutch intensive care patients had blood clotting in an April 10 study published in Thrombosis Research.

Between 20 and 40 percent of COVID-19 patients at Emory University in Atlanta, Georgia, have developed blood clots – even after being put on blood thinners.

One of the doctors behind the latest US study, Dr. Thomas Oxley, said that in the past 12 months, Mount Sinai Hospital had treated an average of 0.73 LVO patients under the age of 50 .

That’s less than two people a month, a stark contrast to the five they treated in the past two weeks.

The neurosurgeon said the five patients were in their 30s and 40s and had mild symptoms or no symptoms of the infection.

He said one died, while the others were either in rehabilitation units, in the stroke unit, or in intensive care.

A patient has been allowed to go home but will need 24/7 care for the rest of his life.

The research, which has yet to be reviewed, is to be published in the New England Journal of Medicine next week.

Doctors said younger patients are less likely to call an ambulance because they heard how overwhelmed hospitals are with coronavirus, but urged them to do so if they have symptoms. virus or stroke.

When a blood clot reaches the brain, brain cells die because they don’t get the oxygen they need.

The longer a blood clot stays in the brain, the more cells die and the damage to the brain spreads.

It is therefore vital that treatment is sought quickly. “The most effective treatment for large strokes is clot recovery, but it must be done within six hours, and sometimes within 24 hours,” said Oxley.

29-year-old Chinese doctor dies of stroke after battling frontline coronavirus for 35 consecutive days

A 29-year-old Chinese doctor died of a stroke after fighting the coronavirus for 35 days without interruption.

Dr Dong Tian, ​​an anesthesiologist, was pronounced dead in a Hubei hospital a week before his 30th birthday in March.

The doctor worked continuously on the front line for more than a month before collapsing and being rushed to hospital on March 3.

According to reports, he was treated in the intensive care unit for 19 days before he died. He left his wife and father sick.

Dr. Dong, who cared for his sick father at home, volunteered to return to work in late January as the epidemic quickly swept through Hubei Province, the former epicenter of the coronavirus.

On February 29, the doctor was given a break after working 35 days in a row. He was placed in segregation due to quarantine requirements.

The anesthesiologist was rushed to the hospital when he had a sudden headache and began to lose his ability to speak during his forties.

Zhijiang People’s Hospital, where Dr. Dong worked, announced his death on March 21.

“Comrade Dong Tian has been efficient and proactive in his work,” said the hospital. “He respected leaders and was kind to his colleagues. “

“Dong Tian is an exceptional representative of” millennial doctors “,” wrote his medical college in a separate statement.

“He used his life to express his kindness and love as a doctor. He sacrificed his youth and his passion for his medical career.

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