Understanding the Connection Between COVID-19 and Stroke

Date: Feb 19, 2021

For healthcare providers and researchers, the COVID-19 pandemic is challenging, but it also presents an opportunity to better understand how this virus affects the body. While we’re getting better and better at slowing the spread, treating those who become ill, and now have a vaccine, there are still many questions that remain on the symptoms and side effects caused by COVID-19 and how they vary between patients.

Recently, researchers at Emory conducted a study that explored the relationship between stroke and COVID-19 patients. The results were clear: Researchers found that rates of unexplained stroke were higher among COVID-19 patients.

While that can sound alarming, it’s important to take a deeper look at the study and what researchers were investigating.

Understanding Stroke and Its Causes

The most common type of stroke is an acute ischemic stroke. This is a stroke that occurs when blood flow to an area of the brain is suddenly stopped. Ischemic strokes can be caused by a blood clot or atherosclerosis (a narrowing of the arteries). If there is no known cause for a stroke; if, for example, a doctor cannot find a blood clot or narrowed arteries, then the stroke is considered cryptogenic (unexplained).


Stroke and COVID-19

During the study, researchers looked at COVID-19 patients who had experienced an ischemic stroke and were receiving care at one of Emory’s hospitals. Out of 396 patients admitted to the hospital with an ischemic stroke, 13 were diagnosed with COVID-19. What was truly interesting to researchers was the rate of unexplained stroke in COVID-19 patients.

Even more concerning for researchers – and care providers – is that many COVID-19 patients took longer to realize they had experienced a stroke or recognize its symptoms. That translates to a longer delay in seeking care, which is an important component of recovering from a stroke.

Researchers believe that this delay may be caused by a variety of factors – from COVID-19 patients feeling poorly overall to difficultly identifying more subtle signs of stroke, especially if patients need respiratory support, such as a ventilator.

“Cryptogenic strokes generally only account for 10-30% of all strokes, but in our study we found that 69% of COVID-19 patients had an unexplained stroke,” says Dinesh V. Jillella, MD, neurologist at Emory Healthcare.

Searching for the Link Between Stroke and COVID-19

Like many aspects of COVID-19, researchers and providers aren’t completely sure of the connection between stroke and the virus. One theory is that COVID-19 causes increased clotting throughout the body, which may, in turn, increase the risk of stroke.

One thing is clear from the research: More work is needed to find the link between these two serious health conditions and health care workers need to be trained to identify those subtle signs of stroke in COVID-19 patients.

Understanding Your Risk

It can be frightening to read of yet another unknown in the COVID-19 pandemic. However, it’s important to remember that not all individuals who become ill with COVID-19 have a high risk of having a stroke. Researchers in the Emory study found an increased risk of stroke in COVID-19 patients with certain pre-existing health conditions, including:

  • Diabetes
  • Hypertension
  • Hyperlipidemia
  • Atrial fibrillation/flutter

Males and African Americans were also predominantly affected by stroke in the study. If you or a loved one are at risk of a stroke, or any complications of COVID-19, continue taking important safety precautions, like the 3Ws:

  • Wear a mask
  • Wash your hands frequently and properly
  • Watch your distance (keeping at least six feet apart from others)

Stroke Symptoms

Stroke experts have created the acronym B.E. F.A.S.T. to help you spot symptoms of a stroke more easily. Here’s what to look for:

B – Balance. Sudden loss of balance or coordination.

E – Eyes. Loss of vision in one or both eyes.


F – Face. Weakness on one side of the face.

A – Arm. Weakness or numbness of an arm.

S – Speech. Slurred speech or difficulty speaking

T – Time. Time to call 9-1-1 if any of these symptoms occur.

Learn more about stroke care at Emory Stroke Center or call 404-778-7777 for additional information.

Emory Brain Health Center

The Emory Brain Health Center uniquely integrates neurology, neurosurgery, psychiatry and behavioral sciences, rehabilitation medicine, and sleep medicine and transforms patient-centered care for brain and spinal cord conditions through research and discovery.

Bringing these specialties together allows more than 400 researchers and clinicians from different areas to collaborate to predict, prevent, treat, or cure devastating diseases and disorders of the brain more rapidly. These collaborations are demonstrated in numerous centers and programs across the Brain Health Center, including the Epilepsy Center, Pituitary Center, Stroke Center, Treatment-Resistant Depression Program, and Veterans Program.

Emory’s multidisciplinary approach is transforming the world’s understanding of the vast frontiers of the brain, harnessing imagination and discovery to address 21st-century challenges.

Learn more about comprehensive, diagnostic, and innovative treatment options at the Emory Brain Health Center.

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