Recurrent strokes are a huge cause for concern as with each stroke there is further accumulation of disability. There are various vascular risk factors responsible for recurrent stroke. However patients without any traditional risk factor or recurrence of stroke despite of best medical management should be screened for rare but important causes for stroke recurrence, once such cause being hypereosiniophilia. Although rare, Hypereosinophilic syndrome (HES) can cause recurrent ischemic stroke. Underlying pathogenesis of hypereosinophilic syndrome could be heterogeneous but cardioembolism is the most common etiology for stroke. Also there is eosinophilia mediated cytotoxicity and release of proinflammatory cytokines contributing to tissue damage and multiple organ involvement and recurrent stroke. Here the authors describe a case of a middle aged gentleman presenting with recurrent strokes over a period of 3 years. He had other risk factors like dyslipidemia and despite of dual antiplatelet therapy and statins he continued to get recurrent strokes with increasing severity. Extensive laboratory workup ruled out other etiologies for the strokes and the only possible causative factor which could be identified was hypereosinophilia. Work up for hypereosiniophilia was negative. After starting steroids and normalisation of eosinophil count, there was no further recurrence of stroke.

Background: The COVID-19 infection can result in prolonged illness in those infected irrespective of disease severity. Infectious diseases are associated with a higher risk of mood disorders. A better understanding of convalescence, symptom duration, as well as the prevalence of depression among recovering patients, could help plan better care for the survivors of COVID-19. Aim: The study aimed to estimate the immediate and short-term prevalence of major depressive disorder and its correlation with continued symptom experience. Methods: In this non-interventional, observational, and cross-sectional telephone survey study, 273 participants were included from January 2021 to April 2021 and 261 completed follow-up by July 2021. The symptoms at the time of RT-PCR testing and during the two phone calls were captured and the Patient Health Questionnaire 9 item (PHQ-9) version was administered. Results: During the immediate and short-term period following COVID-19, 144/261 (55.1%) and 71/261 (27.2%) patients had not returned to usual health, respectively, and 33/261 (12.8%) and 13/261 (5%) of the patients developed depression, respectively. The binary logistic regression analysis revealed that the independent predictors of depression in short-term period following COVID-19 were comorbid diabetes mellitus (OR = 32.99, 95% CI- 2.19-496, P = 0.011), number of symptoms at the time of RT-PCR testing (OR = 1.89, 95% CI 1.23-1.92, P = 0.018), and number of symptoms at short-term period following COVID-19 (OR = 2.85, 95% CI 1.47-5.51, P = 0.002). Conclusions: Individuals with a greater number of symptoms at the time of RT-PCR testing, with post-COVID symptoms persisting 3 months later, and those who have comorbid diabetes mellitus, are at greater odds to have comorbid depression.