Post-Covid Stroke, Heart Attack On The Rise: Experts
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A mild bout of Covid-19 took a drastic turn for a 36-year-old who suffered from a stroke and is now battling paralysis. Chandrashekar Reddy, father of two and the family’s main breadwinner, is barely able to sit up now after over a month. Doctors say a complete recovery could take more than six months, a second brain surgery and intensive physiotherapy.

Reddy’s case, however, is not rare. Doctors have increasingly been seeing cases of stroke and heart attacks in patients who are recuperating or have recovered from Covid. In the second wave, doctors are particularly seeing a delayed presentation of these complications. Worryingly, neurologists say the high incidence of stroke is also seen in patients battling mucormycosis, the invasive fungal disease. The state Covid taskforce has also asked doctors to focus on post-Covid cerebrovascular complications.

Dr Viswanathan Iyer, a brain and spine surgeon who operated on Reddy, said it was his fourth such surgery since the end of April. In Reddy’s case, he had to perform a decompression surgery since there was a large clot on the right side of the brain. The surgery is done to remove the bone and give space to accommodate brain swelling. “The systemic inflammation sends the body in some kind of hypercoagulable state, where the blood thickens, making the patient prone to suffer from a stroke,” he said.

At KEM Hospital, neurologist Dr Nitin Dange said they have seen over 20 cases of strokes, heart attacks and aggravation of deep vein thrombosis in patients who have recovered from Covid. “We have seen it mostly in those who had moderate to severe Covid, but even people without comorbidities and from younger age groups have come after 2 months of recovery from Covid,” he said. At KEM, he said, a big percentage of mucormycosis patients have come with stroke. “Eizther the fungus itself messes with the blood circulation. Or once it reached the carotid artery, it compresses it causing a stroke,” he said.

The death of a family member recently left cardiologist Dr Ashish Nabar, a consultant at Thane’s Jupiter Hospital, shaken. The relative, in his 50s, beat Covid only to die of a massive brain stroke seven days later. Five to six days post-discharge, he woke up one morning to find he could not move his right hand and leg and also had difficulty speaking. An MRI showed a huge clot in the carotid artery. A surgery was done to relieve the swelling, but he went on ventilator subsequently and succumbed two days later.

Head of cardiology at KEM Dr Prafulla Kerkar said those who had moderate to severe Covid with elevated CRP, D-Dimer and IL6 levels should get anticoagulants and antiplatelets post-discharge. But he cautions that the jury is out on whether it should be a blanket prescription to everyone or to a subset of patients.

Source:
https://health.economictimes.indiatimes.com/news/industry/mumbai-post-covid-stroke-heart-attack-on-the-rise/83102741
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