Dr. Oleg Vinogradov, MD: Diabetics and hypertensives are at risk of stroke after overcoming covid

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Dr. Oleg Vinogradov, MD: Diabetics and hypertensives are at risk of stroke after overcoming covid
Dr. Oleg Vinogradov, MD: Diabetics and hypertensives are at risk of stroke after overcoming covid
Anonim

How common is stroke after covid and which people are at risk? Here is the comment of the Russian neurologist - Dr. Oleg Vinogradov, MD, member of the International Stroke Organization.

Dr. Vinogradov, are people worried about how often strokes happen after covid?

- The overall rate of strokes after all forms of covid, including mild and asymptomatic, fortunately turned out to be lower than expected - an average of 1.3%. For those who have experienced severe covid, however, especially a cytokine storm, the risk is significantly higher. Two main groups of people can be distinguished, for whom the danger of a vascular accident when infected with the coronavirus is increased.

The first are patients who already have risk factors for stroke - hypertensive disease, diabetes mellitus, atrial fibrillation, impaired blood supply to the brain, etc. Covid leads to destabilization of the state.

Let's say the person has a serious heart rhythm disorder. The heart contracts unevenly, the blood stagnates in the left atrium, and the risk of blood clots there practically increases fivefold.

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If such a patient is infected with covid and does not take anticoagulants, especially in conditions of dehydration, a thrombus forms, breaks off and enters the cerebral artery, developing an ischemic stroke. In this case, the adverse changes induced by the coronavirus infection destabilize the already existing cardiovascular risk factors.

The second group is the patients with severe course of covid. This in itself can lead to the creation of conditions for thrombus formation. We see young men, 35-40 years old, who have had a thrombus form in their carotid artery, block it and lead to a stroke. Without this young man having any risk factors.

Does the increased risk of stroke in those with pre-existing conditions also persist as long as other symptoms such as shortness of breath, weakness, "brain fog", etc.?

- No. According to research data, the risk of stroke for those who have passed covid is highest in the first weeks after discharge from the hospital, up to a month and a half to two months.

If a person has had covid and wants to check how high their risk of stroke is, as well as reduce this threat, what should they do?

- The approaches to the prevention of strokes in those who have contracted the coronavirus are the same as in other people. It is necessary to find the risk factors for stroke and correct them - to select an individual scheme for prevention. One of the tests that can determine if you have cholesterol plaques is a duplex scan of the brachiocephalic arteries.

It is important to keep the accompanying diseases under control with the help of medicines, proper nutrition, physical exercises. In the first place are hypertension, elevated cholesterol, diabetes mellitus.

No less important is a he althy lifestyle in general: giving up smoking and alcohol abuse; regular exercise; losing excess weight, etc.n. And patients who have experienced covid in a severe or moderate form must take anticoagulants (blood thinners) at least 30-40 days after discharge from the hospital.

They lower the risk of stroke and blood clots in the veins of the legs. But only when such treatment is justified. Because with arbitrary intake of anticoagulants, the consequences can be sad, almost reaching a hemorrhage with a fatal outcome.

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