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Doctors Find Some Younger COVID-19 Patients Suffer Serious Strokes

STEVE INSKEEP, HOST:

A team of doctors says it has new and troubling observations about COVID-19 patients. The team from Mount Sinai Health System in New York is publishing a letter in The New England Journal of Medicine today. They say they found a small number of patients in their 30s and 40s suffering strokes. Dr. J Mocco is director of the hospital's Cerebrovascular Center, and he joins us from - it sounds like a lot of birds there outside New York City. Good morning.

J MOCCO: Good morning. How are you?

INSKEEP: I'm doing OK. You're certainly in a pleasant-sounding spot but disturbing news here. What is notable about people in their 30s and 40s suffering strokes while also suffering from COVID-19?

MOCCO: This was a bit of an alarm for all of us. We saw a seven times increase in the number of patients in their 30s and 40s who were presenting with severe strokes. And those patients did not have many of the typical risk factors we worry about for stroke. And this immediately alerted us that it's likely the disease has a component that's causing clots and potentially putting people at increased stroke but also other diseases caused by clots - renal failure, heart attacks and other things.

INSKEEP: I guess we should explain you're talking about blood clots. That is a factor in a stroke. And it's unusual, isn't it, to have people that young suffering strokes in any numbers at all.

MOCCO: That's exactly correct. And in fact, during the peak of the surge of coronavirus across New York City, we saw a doubling of all of the strokes overall that we saw of severe strokes like this. And what we noticed was that over half of the patients were positive for COVID-19. And those patients behaved very different - looked very different than the normal stroke population. They looked younger, they were more likely to be men, things that made us realize that - appears very strongly there's an association between coronavirus and having these strokes and forming these blood clots.

INSKEEP: Have you seen enough such patients to be sure this isn't just a random occurrence?

MOCCO: We have. So our initial urging communication to The New England Journal, which has just come out, was more of an alert. It was only five patients that were very young. But it was such a stark contrast that it drew our attention. We've now analyzed all of the strokes seen over that period, and there's clearly a strong association identified.

INSKEEP: So what you think is happening is that something about having COVID-19 causes people who wouldn't otherwise have this problem to have a kind of thickening of the blood or clotting of the blood. That is - that's the process here, the virus goes directly to the blood clot?

MOCCO: That is exactly what it looks like. In fact, after noticing this trend, we started talking to our colleagues in pulmonology, the lungs or in the kidneys. And they started telling us they're also seeing blood clots form a lot. And it's really developed our understanding of the disease. And in fact, there was a paper just published recently last week in Lancet that showed how the virus can directly infect the lining of the blood vessels, the cells that protect the blood from clotting. And if that's the case, it's likely that those cells that are getting infected are being disturbed, being injured and that's causing blood clots.

INSKEEP: In a few seconds, are you telling me that we should not think of COVID-19 necessarily as a respiratory ailment but as something that could attack any part of the body?

MOCCO: Yes, 100%.

INSKEEP: Well, Dr. Mocco, thanks for the update. I really appreciate it.

MOCCO: No problem. I hope it was helpful.

INSKEEP: It certainly was. Dr. J Mocco is director of the Cerebrovascular Center at Mount Sinai in New York City and among the doctors reporting a series of strokes among patients in their 30s and 40s who were positive for COVID-19. Transcript provided by NPR, Copyright NPR.