COVID-19 and the Increased Risk of Ischemic Stroke in Young Adults

The COVID-19 virus and sequelae are responsible for causing significant hospitalizations, long term complications, and mortality. While some recover without incident from COVID-19, there are those that suffer complications and lingering side effects, one in particular is coagulopathy leading to ischemic stroke. Although the incidence of ischemic stroke in young adults under 55 has generally been increasing over the past few decades due to the increase in modifiable risk factors, the overall stroke risk in young adults is still substantially lower than that of older adults. There is evidence to suggest that during and after infection with COVID-19, adults are at an increased risk of stroke due to coagulopathy, however most have underlying stroke risk factors such as atrial fibrillation, hypertension, hyperlipidemia or diabetes. Stroke workup, diagnosis and management essentially remain the same regardless of whether the patient has COVID-19 or not. Vigilance of clinicians to identify these young adults with COVID-19 presenting with stroke symptoms and early intervention is paramount in reducing delays in care and ultimately producing better patient outcomes. More research is needed to determine exactly how much of an increased risk of stroke there is in adults under 55 and just how long the increased risk lasts after infection with COVID-19.