​Leading stroke charity funds first study into long-term impact of Covid-19 on stroke

The Stroke Association is funding the world’s first study to determine the long-term impact of Covid-19 on stroke survivors. Since the start of the Covid-19 pandemic there have been widespread reports of adults with the virus also having strokes [1]. The charity announces this new study today, amid concerns that the virus may be causing more severe strokes in patients [2] whom doctors are struggling to treat.

It is thought that the virus could be increasing the chance of blood clots forming in the brain and blocking blood flow [3]. The Stroke Association is funding this vital research to investigate the difference the virus could make to stroke recoveries, which are already at risk due to disruption to stroke services caused by the pandemic [4].

The study will establish which differences in patients with and without the virus may influence their needs for treatment and care, including how to avoid the risk of having further strokes.

Researchers at University College London Hospitals NHS Foundation Trust (UCLH) will follow up to 4,000 stroke survivors, with and without Covid-19 from across 13 emergency stroke units. Stroke recovery, rehabilitation and health will be tracked for up to 18 months after their stroke. Researchers will collect and assess comprehensive, specialist medical information from stroke patients, including brain scans, blood samples and measures of disability. The findings will help to understand how Covid-19 impacts stroke recovery and which treatments might best support survivors’ recoveries.

Dr Richard Perry, lead researcher at UCLH, said: “Research that compares stroke in patients with and without Covid-19 is essential to understand if Covid-19 results in more severe strokes, where survivors will need more support to recover from its devastating effects. While redeployed to stroke wards at the start of the pandemic, I would see patients admitted with unusual strokes, who would then go on to have a positive Covid-19 test.

“The findings from this study will inform decisions about the most effective treatment and the rehabilitation needs of this group of patients, including prevention of recurrent stroke. We already know that from the moment a person has a stroke or mini-stroke they are at substantial increased risk of further strokes [5].

“We’ve come a long way since the start of the pandemic. I’m incredibly proud of stroke doctors and researchers throughout the UK who generously gave their time to contribute to the early stages of our study on the impact of Covid-19 on stroke, when we had no resources and were entirely dependent on their goodwill. This much-needed funding means we can continue the urgent work.”

Stroke is a sudden brain attack, stroke strikes every five minutes, and there are more than 1.2 million stroke survivors living in the UK. However, this is set to rise; it is predicted that the number of stroke survivors aged 45 and over could rise to 1.4 million in 2025, and 2.1 million in 2035 [6].

Active grandmother of two, Michele Hall, 64 from Westby, Preston, is recovering after contracting Covid-19 in March 2020, and going on to have a stroke and multiple TIAs (mini-strokes).

Michele and her husband Stephen went to Paris at the start of March 2020 but after returning, she started to feel unwell. Michele said: “I had severe flu like symptoms including breathlessness, nausea, muscle aches, loss of taste and smell and a feeling of doom.”

After continually contacting her GP and visiting Covid clinics, Michele got an urgent care appointment, where she was told her blood pressure was alarmingly high and continuing to rise. She was taken straight to Blackpool Victoria Hospital by paramedics where she was given medication and discharged home. However, after months of battling fatigue, muscle and joint pains and headache, Michele called her GP again.

She said: “At this point again I couldn’t walk. I was told to go to A&E where I got worse, I couldn’t speak by this point. Eventually a junior doctor told me that my potassium levels were low and at this point I asked whether I’d had a mini stroke and ask if I could have a CT scan. An MRI scan identified that I’d indeed had a stroke, but it wasn’t new and could have occurred when my blood pressure had been so elevated in March.”

Michele was discharged with new medication, but explains: “Within a week, I was back in the hospital because I felt extremely unwell, I took my blood pressure and it was extremely high – I just knew something was going to happen. I get feelings of anxiety, feeling of doom, aches and pains beforehand and then my blood pressure goes up.”

However, nothing further was identified and so Michele was discharged.

Michele said: “I tried to carry on as normal up until Christmas, but on Christmas Day I felt awful. My face started to feel funny and I said I think I’m having a stroke. We called the paramedics and as they arrived, I lost the power of speech.”

Michele was taken for an emergency CT scan and was told she’d had a TIA (mini-stroke). She said: “I was an extremely active person who swam, ran and cycled most days. I have a healthy diet and have never smoked. It made no sense to me that I’d had a stroke. I am now only capable of very gentle exercise and still suffer from bouts of fatigue.”

Dr Rubina Ahmed, Research Director at the Stroke Association, said: “Stroke is a leading cause of adult disability in the UK and the second biggest killer in the world. It’s extremely concerning that we’re seeing strokes happening in ways we have not seen before. This research is absolutely critical in understanding and treating stroke after Covid-19, to help reduce the devastating effects and ultimately improve lives. Covid-19 is here to stay, so it’s vital we can prevent and treat strokes linked with the virus.

“The pandemic has shattered our fundraised income and is threatening research that drives life-changing breakthroughs in stroke care. As a result of the pandemic, we have had to halve our budget for stroke research. Research improves treatment and care for people affected by stroke so they can live their best lives possible, and that’s why stroke research is worth saving. Now more than ever, we need the public’s support. If you can, please help us find a way through the research funding crisis by donating today, so that we can fund more life-saving research.”

In February, the Stroke Association announced the world’s largest study to confirm if Covid-19 increases the risk of stroke and by how much. Together with the new research announced today, the two studies will help doctors to prevent and best treat Covid-19 strokes in the people who are most at risk.

Over the past 30 years the Stroke Association has played a crucial role in supporting stroke research in the UK. Research helps stroke survivors rebuild their lives, but the pandemic has hit research hard. By saving stroke research, more sure stroke survivors can live life to the full.

Find out how stroke research helps rebuild lives at stroke.org.uk/rebuildinglives or to donate, please visit: stroke.org.uk/saveresearch