THE HEART AND BRAIN IN DANGER TOO
Swedish study throws up the independent risk of heart attacks and brain strokes that Covid-19 raises in patients
I have operated on multiple such patients in the last one year. The good thing is that all such patients recovered well. We wait for a minimum of two weeks and ideally 1 month after the patient gets a negative RTPCR report and assess the lung involvement and damage
— DR PRATEEK BHATNAGAR
The ongoing Covid-19 pandemic has wreaked havoc on people. According to a recent study in Sweden, it increases patients’ risks for heart attack and stroke. The study compared 86,742 individuals infected with SARS-CoV-2 in 2020 and 348,481 people without the virus. In the week following a COVID-19 diagnosis, the risk of a first heart attack went up three-to eight-fold, and the risk of a first stroke due to a blood vessel blockage rose three-to six-fold, the researchers found.
The risks then dropped steadily but remained elevated for at least four weeks, according to a report in The Lancet. The researchers did not include COVID-19 patients who had had heart attacks or strokes in the past, but for this group, the risk of another heart attack or stroke is probably even higher, said co-author Dr Anne-Marie Fors Connolly of Umea University.
According to Dr Prateek Bhatnagar, Director Cardiac Surgery, Care Hospitals, “The basic pathology of inflammation in Covid-19 leads to a hypercoagulable state and also increases pre-existing blocks in coronary arteries.”
The doctor, who, in July 2020 performed India’s first coronary bypass surgery on a patient who had recovered from Covid-19 pneumonia but later suffered increasing angina, said, “I have operated on multiple such patients in the last one year. The good thing is that all such patients recovered well.” He adds, “We wait for a minimum of two weeks and ideally 1 month after the patient gets a negative RTPCR report and assess the lung involvement and damage,” he says. Most Covid-19 patients who have a negative RTPCR report can undergo bypass surgery at a routine risk according to him, if they have adequate pumping of the heart while patients with critical blocks and pumping loss will have a higher risk. Dr Bhatnagar however notes that patients who develop Covid-19 immediately after a surgery may have suboptimal prognosis.
“Sadly there are no precautions that people can take to avoid developing these symptoms.
They have to take vaccines and make sure they maintain Covid19 appropriate behaviour, particularly those who are known to have blocks in their coronary arteries,” is his advice.
Dr Shyam K
Jaiswal, consultant neurologist, Care
The prognosis is poor; most are associated with co-morbidities like diabetes and hypertension. Early awareness of a stroke possibility is key — once an imminent stroke is suspected, immediate CT brain/MRI brain needs to be done. If detected within 4.5 hours, we can reverse the effect of strokes — DR BVS RAJU, Neuro Spine Surgeon
Hospitals, endorses the study’s findings. “Covid-19 causes the blood to thicken, leading to
problems of the
brain, heart, and kidney. We put Covid-19 patients on blood thinners to avoid blood clots leading to brain
stroke.,” he explains. Over 80% of the brain stroke cases develop within 72 hours of the Covid-19 diagnosis, shares Dr BVS Raju, Neuro Spine Surgeon, Aster Prime Hospital. “The prognosis is poor; most are associated with co-morbidities like diabetes and hypertension. Early awareness of a stroke possibility is key — once an imminent stroke is suspected, immediate CT brain/MRI brain needs to be done. If detected within 4.5 hours, we can reverse the effect of strokes,” he notes.