Large vessel strokes in young patients with COVID-19..........

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Marcus Aurelius
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8:12p, 4/28/20
AG
https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=featured_home

I have heard about this. But haven't seen it firsthand. NEJM reports a small series of 30 y/o's presenting with carotid or vertebral artery CVAs associated with COVID-19. Rare and unusual. But scary nonetheless. Likely related to the pro-thrombotic state.
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Aggie95
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8:26p, 4/28/20
AG
don't understand a lot of medical articles, but have heard this written elsewhere. Are these strokes and clotting issues presenting themselves in asymptomatic or non-symptom COVID positive patients?
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Marcus Aurelius
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In reply to Aggie95 • 8:28p, 4/28/20
AG
Most had typical COVID-19 symptoms to start and then stroked.
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Marcus Aurelius
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In reply to Joe Exotic • 9:26p, 4/28/20
AG
Regardless of obesity or age. It is sharing of medical information. So providers can be more aware. And learn about this novel virus. Not trying to "exaggerate it" or politicize it. Geez. Exhausting. NEJM the most premiere medical journal on planet. Rare findings are important. This is how the medical field tries to understand novel diseases.
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RikkiTikkaTagem
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9:30p, 4/28/20
AG
People are probably in the above average -thrombotic State compared to average person. These are the people who will get blood clots after knee surgery or someday when they have DM, HTN, CAD, they'll get CVAs. COVid just revealing that about them
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Learned2Code
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9:42p, 4/28/20
Dr. Fauci talked about this today. Could be an explanation of rapid deterioration. They're working on protocols for these secondary effects of infection.

https://www.cnn.com/videos/tv/2020/04/28/lead-dr-fauci-live-jake-tapper.cnn

(Skip to 6:10)
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Player To Be Named Later
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In reply to Marcus Aurelius • 9:46p, 4/28/20
AG
Marcus Aurelius said:
Regardless of obesity or age. It is sharing of medical information. So providers can be more aware. And learn about this novel virus. Not trying to "exaggerate it" or politicize it. Geez. Exhausting.


Thanks for sticking with it and bringing us your first hand experiences Doc. Hopefully you know these type of guys are more of an exception than the rule... even though it is exhausting I'm sure.

Hell, the name of this forum is "Covid News & Information...... seems like this is absolutely Covid Information.
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John Francis Donaghy
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In reply to Marcus Aurelius • 10:31p, 4/28/20
Thank you for posting Marcus. I'm not a doctor, but I really appreciate your insights. I hope the information you and the other docs share between yourselves here can help you all save lives. Stay safe.
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Capitol Ag
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8:12a, 4/29/20
AG
And keep bringing the info Doc. Ignore the haters...


ANd to those that are tired of the lock down and want to reopen, I do to. But I want to know what's going on as well. Stop crapping on a thread from a medical professional when he even states the word "rare" in the OP. Heck, these are things that are good to at least know and file away in case we or anyone we know gets the disease. I appreciate the information.
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bay fan
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In reply to Player To Be Named Later • 8:31a, 4/29/20
S
It's the guys who hang out on 16 and look for a fight that are coming over here because most normal posters can't tolerate that board. If the argument won't come to them, they will come to argue. Glad to see the mods finally eliminating their posts. Hope it's coming with suspensions to allow the majority of posters on this forum to not be driven away.
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Player To Be Named Later
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In reply to bay fan • 8:43a, 4/29/20
AG
New policy of mine going forward. If the large majority of one's posts are in the Politics Forum, to the Ignore I go. I weeded all of the overly political types off of my FB account and it made things so much better. The older I get, the less I have time or patience for overly political bickering. If that's what someone enjoys to do on the internet, then it's very likely that isn't the kind of person I want to have anything to do with.

Too many people absolutely let politics run their life.... there's far too many better things in life than that nonsense IMO.
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Beat40
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In reply to bay fan • 9:13a, 4/29/20
bay fan said:
It's the guys who hang out on 16 and look for a fight that are coming over here because most normal posters can't tolerate that board. If the argument won't come to them, they will come to argue. Glad to see the mods finally eliminating their posts. Hope it's coming with suspensions to allow the majority of posters on this forum to not be driven away.
Edit for part of the reason I even made a response was for a post that I was responding to was removed as well.

I'm thankful for the sharing of information that happens on this board. I think it's proven to be very useful. I'm not here to derail from those efforts. So I'll stick to reading stuff from the docs that I don't fully understand.
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Article 58-10 Offender
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9:33a, 4/29/20
a friend of my wife who is in her late thirties had a stroke about a week ago. she didn't have any COVID symptoms (that I know of), and the stroke came out of the blue. not sure if she has since been tested for COVID, but i do know she was in pretty good health before the stroke.
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9:46a, 4/29/20
AgsMyDude
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In reply to Article 58-10 Offender • 10:39a, 4/29/20
AG
Article 58-10 Offender said:
a friend of my wife who is in her late thirties had a stroke about a week ago. she didn't have any COVID symptoms (that I know of), and the stroke came out of the blue. not sure if she has since been tested for COVID, but i do know she was in pretty good health before the stroke.

How is she doing, she make it?
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swc93
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10:45a, 4/29/20
AG
My 34yr old cousin had a stroke earlier this week. No news if COVID related but it naturally was my first thought.

Regardless; really feel for him being in ICU all alone because of the distancing thing.
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Player To Be Named Later
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10:49a, 4/29/20
AG
This leads me to a question for the docs. Does a daily low dose aspirin help at all with this type of issue as much as it helps potential heart problems? Same principle correct?
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Rachel 98
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In reply to [removed post] • 10:52a, 4/29/20
AG
jj9000 said:
Explains why (in January) we were seeing Twitter videos of Chinese men walking down the street and falling out dead.

Was dismissed as being drunk back then.


Yikes, I didn't see these!!
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In reply to Rachel 98 • 11:12a, 4/29/20
VKint
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In reply to Marcus Aurelius • 11:28a, 4/29/20
AG
Thanks for the post, very interesting to look at the table closely. There is so much virus related email these days I had not read it.
What are you guys using to anticoagulate? Starting upon admission? It istempting to put outpts on ASA that have symptoms even without definitive diagnosis for a while.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Marcus Aurelius
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In reply to VKint • 11:35a, 4/29/20
AG
Heparin GTTs. Yes. If I get it I'm taking ASA 325mg daily.
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Article 58-10 Offender
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In reply to AgsMyDude • 11:35a, 4/29/20
AgsMyDude said:
Article 58-10 Offender said:
a friend of my wife who is in her late thirties had a stroke about a week ago. she didn't have any COVID symptoms (that I know of), and the stroke came out of the blue. not sure if she has since been tested for COVID, but i do know she was in pretty good health before the stroke.

How is she doing, she make it?
yes, sorry, i guess i left out the fact that she survived. it was fairly serious, to the point of them having to remove a portion of her skull to relieve pressure. she has some slurred speech and will require physical therapy as well. i believe she lives down in Victoria, where my wife is from.

edit - just talked to my wife about her. she is from Victoria but was life flighted to Houston from the ER. she is still in pretty rough shape, but was able to Zoom with her family a few days ago.
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Signel
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11:44a, 4/29/20
AG
I seem to remember this kind of damage being described in the Kurzgesagt Covid19 video.

Once the immune response goes crazy, it can attack the healthy cells or something similar. I would figure this would play right into the role of strokes and clots. Wouldn't the IL6 inhibitors possibly prevent the damage to the body by the immune response.

I realize correlation=/= causation, but why does the body have to be in full meltdown mode before the immune system is tricked?
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harge57
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In reply to Marcus Aurelius • 12:52p, 4/29/20
AG
Marcus Aurelius said:
https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=featured_home

I have heard about this. But haven't seen it firsthand. NEJM reports a small series of 30 y/o's presenting with carotid or vertebral artery CVAs associated with COVID-19. Rare and unusual. But scary nonetheless. Likely related to the pro-thrombotic state.
This about sums up this board.
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Aggie95
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In reply to Marcus Aurelius • 1:08p, 4/29/20
AG
Marcus Aurelius said:
Heparin GTTs. Yes. If I get it I'm taking ASA 325mg daily.
is ASA just asprin?
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Marcus Aurelius
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In reply to Aggie95 • 1:09p, 4/29/20
AG
yes
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RandyAg98
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In reply to Aggie95 • 1:12p, 4/29/20
AG
acetylsalicylic acid
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Duncan Idaho
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In reply to Marcus Aurelius • 1:24p, 4/29/20
Marcus Aurelius said:
Heparin GTTs. Yes. If I get it I'm taking ASA 325mg daily.

I stopped taking my daily low dose aspirin when I saw NSAIDs were a potential issue...was that a mistake?
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Marcus Aurelius
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In reply to Duncan Idaho • 1:29p, 4/29/20
AG
Think the NSAID theory was debunked. ASA is more anti-platelet effect than anti-inflammatory like the NSAIDS.
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Duncan Idaho
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In reply to Marcus Aurelius • 1:58p, 4/29/20
Thanks.

When this is over I will buy you at beer at avondale and a pizza at post office pies.
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Marcus Aurelius
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In reply to Duncan Idaho • 2:05p, 4/29/20
AG
Good People Brewery....
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94chem
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2:08p, 4/29/20
I'll just stick with ashwagandha. If I can run 10 miles and not even need to stretch or even get sore, it must be pretty good at anti-inflamatory stuff.
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Duncan Idaho
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In reply to Marcus Aurelius • 2:45p, 4/29/20
Fair enough.. I said avondale because it is next door to post office pies which is the best pizza that I have found in this town.
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AgDoc03
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In reply to Player To Be Named Later • 10:00a, 4/30/20
AG
Player To Be Named Later said:
This leads me to a question for the docs. Does a daily low dose aspirin help at all with this type of issue as much as it helps potential heart problems? Same principle correct?


It doesn't hurt but to treat hypercoaguable states you need actual "blood thinning" agents - Coumadin, Xarelto, Eliquis, Pradaxa vs. anti-platelet agents (aspirin)
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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