MANILA, Philippines — One in every four Filipinos hospitalized for COVID-19 is at risk of having a stroke and other disorders that affect the brain, according to a recent local study conducted by the Philippine Neurological Association.
The retrospective study, presented on Wednesday to reporters in an online roundtable discussion, showed that of the 10,881 Filipinos diagnosed with COVID-19 in 37 hospitals nationwide, 26 percent had neurological symptoms such as headache, altered smell and taste and muscle pain.
It said the other common neurological complications included stroke and encephalopathy (the general term describing a disease that affects the function or structure of the brain), or behavioral changes due to brain damage.
Of the COVID-19 patients covered in the study, 62 percent were mild cases, while 22 percent were severe infections, the study showed.
While most COVID-19 fatalities in the study were caused by respiratory diseases (44 percent) and sepsis or extreme response to infection (41 percent), 23 percent had neurological deficits.
Dr. Epifania Collantes, head of the University of the Philippines-Philippine General Hospital (UP-PGH) stroke services, explained that these neurological manifestations pertained to symptoms affecting the central nervous system, or the brain and spinal cord, as well as the peripheral nervous system, or the nerves and muscles.
COVID-19 patients may experience the symptoms of stroke 14 days before or after they were diagnosed.
The three ways that COVID-19 would cause brain damage, Collantes said, were through direct invasion affecting the olfactory nerves and the brain; decrease in blood flow because of blood clots in the arteries and veins, depriving brain cells of oxygen; and the release of substances such as immune molecules that harm the brain.
Younger victims
Collantes noted that COVID-19 produced stroke patients among the younger population because of changes in the immune system of those infected with the disease.
“We are seeing a lot of young stroke patients, even though they have no history of high blood or diabetes, or even if they are not smokers, because COVID can cause blood clots not only in the heart, but also in the brain,” Collantes told reporters.
Another study conducted by the UP-PGH, titled “Stroke in patients with COVID-19 infection in a tertiary hospital: A retrospective study,” had more serious results, with 41 percent of 2,018 COVID-19 patients age 45 to 73 confined at PGH developing an acute stroke.
Fifty-nine percent of them died mainly due to delay in management and medical attention, resulting in severe complications, Collantes said.
“[The] number one reason of stroke mortality in COVID patients last year was that hospitals were full,” Collantes said, adding that medical attention was delayed when patients went around looking for vacancies in hospitals.
“[The] second reason is that strokes in COVID-19 usually are ‘large strokes,’ which can cause death and severe disability,” Collantes added. A stroke is also called a brain attack.
A separate study published in August showed that stroke remained the second-leading cause of death and one of the top five causes of disability in the Philippines from 2009 to 2019.
New cases
World Stroke Day is observed on Oct. 29 to highlight the serious nature and high rates of stroke, raise awareness on the prevention and treatment of the condition, and ensure better care and support for survivors.
Meanwhile, the Department of Health on Wednesday reported 3,218 new COVID-19 cases, continuing the decline in new infections for the fifth straight day.
The latest tally pushed the total number of cases throughout the country to 2,768,849.
Active infections fell to 50,152 from the previous day’s case count. Majority or 73.4 percent of the cases were mild, while the rest were moderate (11 percent), asymptomatic (6.8 percent), severe (6.2 percent) and critical (2.6 percent).
There were 6,660 new recoveries, bringing the total number of survivors to 2,676,349. The country’s death toll rose to 42,348 after 271 fatalities were registered.
The country’s positivity rate is also on a downtrend at 7.6 percent, improving from the previous day’s 8.5 percent, after 3,120 turned out positive out of 41,049 tests conducted. This means the country is now slightly above the recommended positivity rate of below 5 percent.