Young and middle-aged people, barely sick with Covid-19, are dying from strokes(washingtonpost.com)
washingtonpost.com
Young and middle-aged people, barely sick with Covid-19, are dying from strokes
https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients/
48 comments
Terrifying. But the silver lining is that they're catching on to the patterns, which means they can start adjusting treatments. I think that beyond just flattening the curve, delaying one's infection date right now probably has a significant impact on survivability simply because of how much we're still learning about this disease every week.
Exactly. People are talking about "moving goal posts" because the curve has already been flattened. But if I get it, I want to be as far out on that curve a possible so doctors know better what to do about it.
The fact that the curve is being flattened is exactly what ALLOWS investigation into these deeper insights.
You can't measure infection rate when your patient is bleeding to death from an arterial wound.
You can't measure infection rate when your patient is bleeding to death from an arterial wound.
People are talking about "moving goal posts" because the goalposts have been moved. In my area, 3 weeks has become 6 weeks, and now that it's close to 6 weeks people I see a lot of comments like yours about whether we really need to go out at all. It's become increasingly clear that some activists think everyone should stay at home forever, and are attempting to trick the rest of us into going along with it by endlessly redefining when it's safe to leave.
I'm fully in support of your individual right to isolate as long as you'd like, of course.
I'm fully in support of your individual right to isolate as long as you'd like, of course.
What a strange conspiracy theory to take up.
In my country there are politicians declaring the 1.5 meter society 'the new normal'.
I just don't see how it's a conspiracy. There are plenty of people who openly say that shutdown measures should be in place for a year or two - the Virginia health commissioner said it just yesterday! The only question is whether they'll be able to make that happen.
> It's become increasingly clear that some activists think everyone should stay at home forever
Who are these sinister activists that are just using the crisis as a tool to achieve their end-game of [checks notes] people never going outside again?
Who are these sinister activists that are just using the crisis as a tool to achieve their end-game of [checks notes] people never going outside again?
Well, as I think you'll find I just mentioned, the Virginia health commissioner is one of them.
They imagine to be living through a pandemic as well?
Amazing. What nerves these people have.
Amazing. What nerves these people have.
I am.
Everyone should work from home.
Everyone should work from home.
It's a conspiracy to stop you from dying from an incurable disease until treatment is available, how sinister!
Oh come on. There is no grand conspiracy to keep the shutdown going for two years. Everyone realizes that would destroy the economy and not a single government official wants to sit at home with their screaming children for two years straight. This is a fake controversy ginned up by the right. Here are the facts:
The Virginia health commissioner said on Friday, "I personally think Phase One will be a two year affair." Phase One involves re-opening of non-essential businesses, continued physical distancing, telework, and face coverings in public.[1]
A few publications on the right interpreted this the worst way possible. Washington Examiner wrote[2], "the top health official in Virginia said the state could be in lockdown for the next two years." Lockdowns are generally defined as the closing of non-essential businesses and requiring a reason for people to be outside the home. It's clear that Gov. Northam's Phase One guidelines are a loosening from the general definition of a lockdown. Federalist[3] decided to interpret this comment as schools remaining closed for two years. Indeed, Gov. Northam's presentation did not touch on schools, but that could just as likely be because a decision on schools hasn't been made yet.
In any case, on Saturday, the health department clarified the comments, saying, "Dr. Oliver intended to say that the Commonwealth will likely be dealing with COVID-19 in some form until a vaccine is produced, not that Phase One itself would take two years."
[1]: https://www.governor.virginia.gov/media/governorvirginiagov/...
[2]: https://www.washingtonexaminer.com/news/top-virginia-health-...
[3]: https://thefederalist.com/2020/04/25/virginia-health-commiss...
The Virginia health commissioner said on Friday, "I personally think Phase One will be a two year affair." Phase One involves re-opening of non-essential businesses, continued physical distancing, telework, and face coverings in public.[1]
A few publications on the right interpreted this the worst way possible. Washington Examiner wrote[2], "the top health official in Virginia said the state could be in lockdown for the next two years." Lockdowns are generally defined as the closing of non-essential businesses and requiring a reason for people to be outside the home. It's clear that Gov. Northam's Phase One guidelines are a loosening from the general definition of a lockdown. Federalist[3] decided to interpret this comment as schools remaining closed for two years. Indeed, Gov. Northam's presentation did not touch on schools, but that could just as likely be because a decision on schools hasn't been made yet.
In any case, on Saturday, the health department clarified the comments, saying, "Dr. Oliver intended to say that the Commonwealth will likely be dealing with COVID-19 in some form until a vaccine is produced, not that Phase One itself would take two years."
[1]: https://www.governor.virginia.gov/media/governorvirginiagov/...
[2]: https://www.washingtonexaminer.com/news/top-virginia-health-...
[3]: https://thefederalist.com/2020/04/25/virginia-health-commiss...
This is not "the worst way possible". There's just no reasonable interpretation of "Phase One will be a two year affair" other than that Phase One will last two years.
Maybe he misspoke! I can't rule that out. But every time I discuss the issue on a forum like this, and I mention that we can't stay locked down until the virus goes away, a few people pop up to say that we totally can and must. I think there's reason for concern that it's not just Internet trolls who think this way - concern that officials are not alleviating by their refusal to give any kind of clear timeline.
Maybe he misspoke! I can't rule that out. But every time I discuss the issue on a forum like this, and I mention that we can't stay locked down until the virus goes away, a few people pop up to say that we totally can and must. I think there's reason for concern that it's not just Internet trolls who think this way - concern that officials are not alleviating by their refusal to give any kind of clear timeline.
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If you’ve got to get sick, you want to be either one of the first, when all resources are available, or one of the last when all the experience is available. You don’t want to get sick in the middle.
Not a doctor, just a thought, could this in part be caused by some sort of Deep Vein Thrombosis or other clots due to people not physically moving as much during quarantine?
A friend from Germany told me that they are looking exactly in this and they found that dead COVID-19 patients had clots. He's a smart and well informed guy and it made sense at the time, but I did not find some primary sources to corroborate.
The part about clots forming literally as the surgeon was operating seems much more exotic than something so simple as reduced activity.
Did the earliest victims of Covid19 also show similar levels of clots? Or are we only seeing elevated levels recently? Could help to plot this over time as the lockdown extends. If there's a correlation, would help to stress the importance of staying active in quarantine, ex: lifting, stationary bike, jump rope.
I think there's a bias in the data because a) lots of people die from the respiratory symptoms before they get a stroke, and b) young people who get a stroke might not know how to recognize it/what to do about it, so they may just stay at home and die there and never get recorded as a COVID death.
Deep vein thrombosis (DVT) is unlikely to cause strokes, as DVT causes clots to form in the venous system, while strokes involve clots in the arterial system. Clots from veins are more likely to get lodged in the lungs (pulmonary embolism) than pass across the lungs into arteries.
The higher prevalence of strokes in COVID patients isn’t fully understood, but might be due a generally increased inflammatory state in the body, with complement (a cascade of proteins involved in immune response) seeming to play a significant role. It’s known that inflammatory states generally increase risk of clotting (eg cancer, surgery) but it remains to be seen if COVID is having a similar effect, or a more direct influence.
The higher prevalence of strokes in COVID patients isn’t fully understood, but might be due a generally increased inflammatory state in the body, with complement (a cascade of proteins involved in immune response) seeming to play a significant role. It’s known that inflammatory states generally increase risk of clotting (eg cancer, surgery) but it remains to be seen if COVID is having a similar effect, or a more direct influence.
There were some preliminary reports about COVID thickening the blood of patients. Clearly preliminary, but it might not be entirely driven by sedentary behavior.
And maybe also dietary changes due to lockdown: Higher sodium, more preservatives, less fruit and vegetables. Less trips to grocery store means buying more food that has a longer shelf-life than people would normally be eating.
I work at a homeless shelter where a young guy in his mid twenties recently had a stroke that left one of his hands completely limp. He's active and outdoors all day, but cannot self-isolate at night because he lives in a shelter.
I was shocked when he told me because he's "fit as a fiddle" otherwise. This article makes some sense of it.
I was shocked when he told me because he's "fit as a fiddle" otherwise. This article makes some sense of it.
"Doctors are often able to reopen blocked blood vessels through techniques such as pulling out clots or inserting stents. But it has to be done quickly, ideally within six hours, but no longer than 24 hours: “The message we are trying to get out is if you have symptoms of stroke, you need to call the ambulance urgently. ”"
After a family member's stroke, we were told that 4 hours is the magic number.
Per the Mayo Clinic: "Therapy with drugs that can break up a clot has to be given within 4.5 hours from when symptoms first started if given intravenously. The sooner these drugs are given, the better. Quick treatment not only improves your chances of survival but also may reduce complications." https://www.mayoclinic.org/diseases-conditions/stroke/diagno...
After a family member's stroke, we were told that 4 hours is the magic number.
Per the Mayo Clinic: "Therapy with drugs that can break up a clot has to be given within 4.5 hours from when symptoms first started if given intravenously. The sooner these drugs are given, the better. Quick treatment not only improves your chances of survival but also may reduce complications." https://www.mayoclinic.org/diseases-conditions/stroke/diagno...
I wonder if anybody's considered packaging these drugs up for home use? A "stroke EpiPen", if you will.
Interesting idea but unfortunately this isn’t feasible, unless you also have access to a full suite of diagnostic equipment at home. Even if someone at home could self-diagnose a stroke with any accuracy, around 10% of strokes are actually caused by haemorrhage (bleeding) rather than a clot. A CT scan is almost always carried out to rule this out, before administering thrombolytic drugs or aspirin, as these drugs can significantly worsen existing bleeding.
This should be surprising to no one really flu and other respiratory illnesses have been known to increase stroke likelihood and severity considerably (upto 40% in the first 15 days), it also increases the likelihood of other cardiovascular conditions including cervical artery (CAD) and neck artery raptures..
https://www.sciencedaily.com/releases/2019/01/190130075757.h...
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.110.59...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899905/
https://www.sciencedaily.com/releases/2019/01/190130075757.h...
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.110.59...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899905/
Mirror:
http://archive.is/6OQQj
Can someone explain to me why the number of daily infections in California is still going up despite home orders. I just saw this and it baffled me (European here).
Latent phase coming to its end, perhaps?
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Is there a non-paywalled link?
Not the same paper, but https://www.medscape.com/viewarticle/929345
First off, yes, Covid is real, it's way worse than flu, social distancing is essential, it's not 5g and not a government conspiracy. But I can not help but wonder - if we were to look for other variables, like, i don't know, eye color, isn't it likely that we would find a similar correlation? What is the model of action here and why are medical professionals so sure it was caused by covid? Maybe covid is a confounding variable, most apparent because we are mostly looking at it now?
> Mocco, who has spent his career studying strokes and how to treat them, said he was “completely shocked” by the analysis. He noted the link between covid-19 and stroke “is one of the clearest and most profound correlations I’ve come across.”
Okay, let's burn more karma. Maybe there is some hidden variable that makes these young people more susceptible to covid. Correlation without a model of action is, well, a correlation. Clots from damaged lungs maybe? But clotting without lung damage is unlikely. It's very weird.
Covid-19 attacks the whole body, including brain, vessels, you name it. They've found Sars-Cov-2 in eyelids. This is exactly why you want governments to be responsible and take precautionairy actions first, because we know next to nothing about this virus and effects. Those who claim otherwise are simply ignorant, because we all are. The science will come later.
Well AFAIR virii are like that - they tend to be found, well, about everywhere, provided viral load is sufficient. That doesn't mean that their protein spike has an affinity (i.e. can bind to and infect) to other cells, so "attacking the whole body" is a bit of an overstatement.
It's just shit luck it targets a receptor that is prevalent in key organs, as it regulates the blood flow. Then again i am not really an expert so let's leave it at that.
On "This Week in Virology", a podcast that's been going on for quite a while but just got popular (imagine that), this was discussed, and the consensus was that there is definitely something going with clotting mechanisms and Covid-19. They started treating with Warfarin and Heparin just like they do with older conventional stroke patients.
It may also be implicated in the kidney failure that seems to associate with Covid
As for me I'm going to keep taking a daily baby aspirin like I have for years. I bleed like a stuck pig when I get a cut, but I can live with that!
It may also be implicated in the kidney failure that seems to associate with Covid
As for me I'm going to keep taking a daily baby aspirin like I have for years. I bleed like a stuck pig when I get a cut, but I can live with that!
That's a very interesting fact. It makes the stroke being caused by covid more plausible.
Young people with covid have strokes at a much higher rate than they do without covid. I could see your point if the main transmission vector for covid were cheeseburgers, but as it is I'm having trouble thinking of a plausible confounding variable.
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