Stroke can be the first presenting symptom of younger patients with COVID-19


LONDON, ONTARIO - Since the start of the COVID-19 pandemic, researchers have been working to better understand and characterize the varied symptoms of the disease. One of the most concerning symptoms is the development of large blood clots that can cause blockages in the arteries that lead to the brain causing stroke.

Researchers at Western University and Lawson Health Research Institute led by Dr. Luciano Sposato have been investigating the relationship between COVID-19 and stroke to better understand the risk in patients and aid in treatment planning. In a new study published in the September 15, 2020 online issue of Neurology, the medical journal of the American Academy of Neurology, the research team reports that approximately two in every 100 patients admitted to hospital with COVID-19 will suffer a stroke, and 35 per cent will die as a result of both conditions. 

The researchers reported that in patients under 50 years old, nearly 50 per cent had no other visible symptoms of the virus at the time of stroke onset. They also found that the interplay of older age, other chronic conditions and the severity of COVID-19 respiratory symptoms are associated with an extremely elevated risk of death.

“One of the most eye-opening findings of this study is that for patients under 50 years old, many were totally asymptomatic when they had a stroke related to COVID-19. This means that for these patients, the stroke was their first symptom of the disease,” said Dr. Sposato, Associate Professor and the Kathleen and Dr. Henry Barnett Chair in Stroke Research at Western’s Schulich School of Medicine & Dentistry, and Scientist at Lawson.
Sposato says understanding the interplay between COVID-19 and stroke is important for treatment planning, especially in areas where COVID-19 is actively circulating in the community. 

“The take-home message here for health care providers is that if you are seeing a patient with a stroke, particularly in those under 50 years old with large clots, you need to think of COVID-19 as a potential cause even in the absence of respiratory symptoms,” said Dr. Sposato. 

The research team completed a systemic review of published cases of COVID-19 and stroke and pooled that data with another 35 unpublished cases from Canada, the USA and Iran. In total, the team examined 160 cases, looking at both clinical characteristics and in-hospital mortality.

“COVID-19 has changed the stroke landscape worldwide. As stroke neurologists, we need a new mindset to be able to promptly diagnose and treat patients with COVID-19 related strokes,” said Dr. Sebastian Fridman, Assistant Professor, Clinical Neurological Sciences at Schulich Medicine & Dentistry, research fellow at Lawson and first author on the study.



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About Lawson Health Research Institute

Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit

About The Schulich School of Medicine & Dentistry

The Schulich School of Medicine & Dentistry at Western University is one of Canada’s preeminent medical and dental schools. Established in 1881, it was one of the founding schools of Western University and is known for being the birthplace of family medicine in Canada. For more than 130 years, the School has demonstrated a commitment to academic excellence and a passion for scientific discovery. 

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