ItHome Cardiac Arrest Covid-19-linked brain stroke cases prompt doctors to prescribe blood thinners long after discharge | Pune News

Covid-19-linked brain stroke cases prompt doctors to prescribe blood thinners long after discharge | Pune News

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Covid-19-linked brain stroke cases prompt doctors to prescribe blood thinners long after discharge | Pune News

Pune: Some Covid-19 patients, city doctors said, have suffered neurological complications — primarily brain strokes — even after making a full recovery.
The new virus mainly impacts the lungs, but specialists said it has been causing blood clots that have triggered brain strokes.
Doctors said renewed concern over these strokes has now prompted them to prescribe blood thinners for a considerable period after discharge.
Patients with other viral infections, including seasonal flu and even bacterial diseases such as TB, can also develop risks of brain strokes due to inflammation of blood vessels, but those numbers are lower than in Covid-19. Experts said this is because ‘excessive clotting’ due to blood vessel inflammation has been a characteristic of Covid-19.
Neurologist Rajas Deshpande, with Jupiter hospital, said, “Covid-19 causes changes in blood that trigger clotting. And when these clots block blood circulation in the brain, it is called brain stroke. I have treated a few patients for the problem.”
Strokes have two main causes: a blocked artery (ischemic stroke) or a burst blood vessel (hemorrhagic stroke).
“We have had 12 cases of brain stroke so far in Covid-19 patients,” said Deenanath Mangeshkar hospital’s intensivists Prasad Rajhans and Balasaheb Pawar. “The brain stroke events are of the ischemic type. None of our patients had hemorrhagic brain strokes. Most had some risk factors, but we’ve had young patients with no known conditions.”
Rajhans said, “We are seeing both brain and cardiac events — but brain strokes have been slightly higher in number. We are prescribing blood thinners to these patients for about one month or more after discharge.”
The doctor added that these are young patients whose blood can have a high tendency to thrombose or clot (hypercoagulabilty). “These patients are relatively younger and do not have any other known risk factors that can cause strokes,” Rajhans said.
A simultaneous attack of Covid-19 pneumonia and organ trouble can complicate stroke management. Low oxygen levels can also worsen severity of brain damage.
Doctor said a few patients suffered strokes after making full recoveries. “This is because the damage caused to the inner linings of blood vessels during Covid infection set off blood clotting, which is completed only after a few days. That can lead to brain strokes,” said Deshpande
He added, “Even abnormal heart rhythms generated by myocarditis — inflammation of the heart muscle — can cause clots for weeks after the infection has subsided. Such clots then cause post-Covid brain strokes.”
But doctors said blood thinners should be used carefully. “Blood thinners can be dangerous and must be used cautiously. If required, they may be used for a few months after discharge depending on pre-exisiting medical conditions,” Deshpande said.
The problem of asymptomatic or mildly symptomatic patients developing clots remains unstudied at present.

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