Assessing the Risk of Stroke in the Elderly in the Context of Long-COVID, Followed Through the Lens of Family Medicine

Abstract

Background/Aim: Patients infected with COVID-19 may experience a range of acute and chronic neurological disorders. While severe neurological complications like strokes and seizures were less common during the acute or post-COVID period, the long-term effects of COVID-19, known as long COVID, have received limited attention. This study aimed to examine the lasting consequences of SARS-CoV-2 infection and establish potential connections with related diseases. Patients and Methods: We followed a group of 157 patients for one year, predominantly from urban areas (61.8%), divided into three groups based on the presence of associated diseases that pose health risks: the control (43 patients), low-risk (67 patients), and high-risk (47 patients) groups. Results: We observed an inverse relationship between oxygen saturation and erythrocyte sedimentation rate, as well as a direct relationship between varicose disease and dyslipidemia, and gastrointestinal disease. Additionally, we noticed a less significant improvement in oxygen saturation and increased prevalence of psychoanxiety disorders in individuals undergoing anticoagulant treatment. Conclusion: The impact of long COVID and its secondary effects, which persist for an extended period and are influenced by associated diseases, can be effectively monitored and addressed by primary care physicians. These findings can serve as a basis for developing more efficient approaches to managing the long-term consequences of COVID-19.COVID-19 patients have the potential to develop various acute neurological disorders, such as loss of taste and smell (ageusia and anosmia), abnormal brain wave patterns (epileptiform abnormalities), brain inflammation (encephalopathy), stroke (cerebral infarction), nerve damage in the extremities (peripheral neuropathy), and muscle inflammation (myositis). The long-term neurological conditions associated with COVID-19 are not yet clearly defined, but commonly reported syndromes include dysautonomia (problems with the autonomic nervous system), neurocognitive dysfunction, different types of pain syndromes, persistent fatigue, and reduced tolerance for physical exertion (1).A retrospective observational case series conducted in Wuhan revealed that a significant proportion (36.4%) of 214 hospitalized patients with SARS-CoV-2 infection exhibited some form of neurological involvement. This indicates that neurological manifestations may be overlooked and not adequately reported in the progression of the disease. Among patients with central nervous system (CNS) involvement, the most frequently reported symptoms were headache (13%) and dizziness (17%). However, more severe neurological complications, such as strokes and seizures, were less prevalent, occurring in only 3% and 0.5% of cases, respectively (2).Antiphospholipid syndrome (APS) is distinguished from other coagulation disorders by its prominent occurrence of arterial thromboses. The most frequently observed arterial thromboses in APS affect the intracranial arteries, resulting in strokes and trans...