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Most people know that high blood pressure (hypertension) puts you at risk for a stroke, a “brain attack” that most often occurs when blood flow to the brain gets blocked. You might know that having diabetes, high cholesterol, being a smoker, and obesity are major stroke risk factors, too.

The link between viruses and stroke, however, is not as well-known — yet it’s very real.

Recently, you might have heard that some patients with COVID-19 are experiencing blood clots and strokes. While it might seem odd that a virus could trigger a stroke, scientists were unsure about the unique nature of this connection. That’s because viruses including varicella zoster (which causes chickenpox and shingles), cytomegalovirus (a common virus related to herpes), and HIV all have the potential to increase stroke risk. So does influenza (flu).

To find out whether coronavirus increases the risk of stroke more significantly than does the flu, researchers from Weill Cornell Medicine in New York reviewed data on patients who were treated at major NYC hospitals. They included people who had been hospitalized with COVID-19 related complications between March and early May 2020, as well as those who were hospitalized with the flu between January 2016 and May 2018.

They determined that hospitalized coronavirus patients were seven times more likely to suffer an ischemic stroke (the most common type of stroke) compared to hospitalized flu patients.

“Furthermore, we found that patients with COVID-19 infection who experienced an ischemic stroke were considerably more likely to die than patients with COVID-19 infection who did not experience an ischemic stroke,” the authors wrote.

The authors also noted that “most ischemic strokes [among COVID patients] occurred in older age groups, those with traditional stroke risk factors, and people of color.” High levels of D-dimer, a protein that plays a role in the formation of blood clots, was also associated with a higher likelihood of having a stroke.

The findings were published in the journal JAMA Neurology.

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Merkler AE, et al. Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza. JAMA Neurology. July 2, 2020. doi: https://doi.org/10.1001/jamaneurol.2020.2730.

Nagel MA, et al. Virus Vasculopathy and Stroke: An Under-Recognized Cause and Treatment Target. Infectious Disorders-Drug Targets. July 2010. doi: https://doi.org/10.2174/187152610790963537.

Stroke Risk Factors You Can Control, Treat and Improve. American Stroke Association.

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