Scientists are still trying to make sense of the disease known as COVID-19. It’s only been six months since the first case was reported in the U.S. As time goes on, we’re starting to learn more about how this strain of coronavirus affects the body. We know some people experience flu-like symptoms, shortness of breath, and some even lose their sense of taste, but others report lack of circulation, stroke, and even a lasting mental fog that can stretch on for months. Some report no symptoms or side effects whatsoever.
The situation is still changing fast as we collect more information on the long-term effects of COVID-19. Let’s look at some of the more unique cases of the disease to find out what’s going on behind the scenes.
Coronavirus and Stroke
Numerous reports are starting to look at the relationship between coronavirus and stroke. A recent one from Thomas Jefferson University shows that exposure to the virus seems to increase the chances of stroke for young, otherwise healthy patients. The results of the report are preliminary and are based on observations from 14 patients who came to a leading neuroscience institute for stroke, with 42% of them under the age of 50.
“We were seeing patients in their 30s, 40s and 50s with massive strokes, the kind that we typically see in patients in their 70s and 80s,” says Pascal Jabbour, MD, Chief of the Division of Neurovascular Surgery and Endovascular Surgery in the Vickie & Jack Farber Institute for Neuroscience at Thomas Jefferson University. “Young people, who may not know they have the coronavirus, are developing clots that cause major stroke,” he explains.
Most strokes (75%) in the U.S. occur in people over the age of 65, but this may not apply to COVID-19 patients. Many people choose to delay being tested for the virus or seeking medical care, which decreases their chances of survival. The authors of the study say there’s a small window of time during which strokes are treatable, so delays can be life-threatening.
The shocking results show us that the mortality rate of the group of 14 stroke patients was 42.8%. The typical mortality from stroke is around 5 to 10%. The incidence of coronavirus in this sample population was 31.5%.
But what does the coronavirus have to do with stroke?
The virus can aggressively attacks the lungs; there are two theories about how it can lead to strokes:
We know that the virus enters and spreads throughout the human body using a protein on human cells known as the ACE2 receptor. This protein is extremely common in cells that line blood vessels, the heart, kidneys, and the lungs. As the virus replicates itself, it may interfere with this receptor’s normal function, altering blood flow to organs.
Another theory is that the virus can lead to inflammation of the blood vessels and vasculitis, causing injury to them. This can result in microthrombosis in small vessels, creating symptoms such as impaired renal function, fatigue, anemia, dyspnea, low platelet count, and more.
Elizabeth Moore, 43, a patient in Northern Indiana, talks about how her blood pressure would start racing in the middle of the night after being exposed to the virus. “I truly thought I had a heart attack or a stroke, like that’s what it felt like to me. It was terrifying,” she said.
One of the most extreme cases of COVID-19 involved a California man that was hospitalized for two months after testing positive for the virus.
Gregg Garfield, 54, was healthy before coming down with the virus after returning to the U.S. following a trip to Italy earlier this year. The country was once a major COVID-19 hotspot in Europe, but has since gotten virus transmission under control.
Now known as Patient Zero, he was admitted to the hospital in March after coming down with flu-like symptoms. He was one of the earliest confirmed coronavirus patients in southern California and the first coronavirus patient admitted to Providence St. Joseph Medical Center in Burbank, 10 miles north of Los Angeles. However, his body started reacting to the virus in all kinds of unexpected ways. His condition deteriorated rapidly as doctors tried to fight off sepsis, kidney failure, liver failure, MRSA, a pulmonary embolism, and more.
He was given a 1% chance of survival.
Garfield eventually recovered, but with a twist. He had to have all of his fingers on his right hand amputated, as well as most fingers on his left, which was a result of losing blood circulation to his extremities from a last-resort medication given to him to try to save his life. Surgeons have already planned a series of at least six surgeries to reconstruct Gregg’s fingers using prosthetics.
“COVID-19 has effects on the endovascular bloodstream, so it actually affects the blood flow,” says Dr. David Kulber, a surgeon at Cedars Sinai Medical Center in Los Angeles. “That’s why some young people have had strokes, and that’s why anticoagulation — putting patients on blood thinners — now has been a standard cure for COVID-19 patients.”
Despite this setback, Garfield is thankful to be alive. Luckily, he survived with his sense of humor intact. He’s already gearing up for his next ski trip – if the slopes are open, that is.
In an exclusive interview, Greg recently spoke to Scrubs Mag about his experience:
How did this happen?
I was on a ski trip in northern Italy back in February and when my girlfriend gave me the heads up that coronavirus had started to show up in northern Italy, but I wasn’t too concerned. Simply because we knew very little about the virus. All 13 of the guys on the ski trip contracted coronavirus. All experienced varying symptoms from asymptomatic to the extreme that I went through.
How do you keep optimistic?
Mindset is everything! I’ve always been a very optimistic person and the power of positivity and high vibrations from my family and my village got me through the 31 days on the ventilator… I feel like I need to live up to this chapter to carry the same positivity going forward.
What are your warnings to people who won’t wear a mask?
Wearing a mask should not be a political issue! There is enough that divides us these days… It’s all about being human and coming together as one human race to cut this thing off at the knees. We have to wear seatbelts to survive, we have to wear helmets and bikes and motorcycles to survive. So for now, while we don’t have a vaccination or cure, we have to wear masks. Not a big sacrifice to avoid a catastrophic situation.
Garfield represents the extreme, but it’s a reminder that the virus can affect the body in surprising, unpredictable ways. Scientists are still trying to fully understand the long-term effects of exposure. Don’t make assumptions about COVID-19, and encourage your patients to err on the side of caution, whether it pertains to wearing a mask or not delaying treatment if they suspect they may be infected.