In this paper recently published in The New England Journal of Medicine, Oxley et al., report five cases of large-vessel stroke in patients younger than 50 years of age affected by SARS-CoV-2 infection. The five cases were observed over a 2-week period from March 23 to April 7, 2020. On admission of the five patients, the mean NIHSS score was 17, consistent with severe large-vessel stroke. By comparison, every 2 weeks over the previous 12 months, the authors reported that their service has treated, on average, 0.73 patients younger than 50 years of age with large-vessel stroke. Coagulopathy and vascular endothelial dysfunction have been proposed as complications of Covid-19, and the authors concluded that the association between large-vessel stroke and Covid-19 in young patients requires further investigation.
https://www.nejm.org/doi/full/10.1056/NEJMc2009787
by Marialuisa Zedde and Francesco Cavallieri