Chinese doctors released chest X-rays of a 33-year-old coronavirus patient that show what the illness looks like in her lungs
A coronavirus outbreak that started in China has killed 213 people and infected nearly 9,900. Researchers at a hospital in Lanzhou just released chest X-rays of a 33-year-old coronavirus patient. The images provide new clues about the nature of the virus. Visit Business Insider's homepage for more stories.
When a 33-year-old woman arrived at a hospital in Lanzhou, China, she'd had a fever and cough for five days. The patient, who is being kept anonymous, had a temperature of 102 degrees Fahrenheit. Her breathing was "coarse," doctors wrote, and she had a low white blood cell count — a sign of infection. Doctors diagnosed her with the new coronavirus that has spread throughout China. As of Friday evening, more than 9,900 cases have been recorded and 213 people have died. In a study released in the journal Radiology on Friday, a group of researchers at The First Hospital of Lanzhou University presented two of the woman's chest X-rays side by side. The scans show white patches in the lower corner of her lungs, which indicate what radiologists call "ground glass opacity." "If you zoom in on the image, it kind of looks like faint glass that has been ground up," Paras Lakhani, a radiologist at Thomas Jefferson University who was not involved in the study but examined the images, told Business Insider. "What it represents is fluid in the lung spaces."
The X-rays provide researchers a few new clues about the nature of the virus. The scans show the new coronavirus looks similar to SARS and MERS Coronaviruses are a large group of viruses that typically affect the respiratory tract. They also cause pneumonia and the common cold. Symptoms of the new coronavirus include a fever, chills, headaches, difficulty breathing, and a sore throat. Until December, it had never been seen in humans. The novel coronavirus was first identified among a small group of people exhibiting pneumonia-like symptoms in Wuhan, China, in December. The 33-year-old patient whose lungs are shown in the new x-rays works in Wuhan, but had traveled to Lanzhou a day before her symptoms started.
"If you didn't know about this outbreak, you'd read the scan and you would just say, 'Okay, this patient has pneumonia,' because that's the most common thing we see," Lakhani said. On its own, he added, ground glass isn't particularly helpful for identifying a coronavirus. "You can see it with all types of infections — bacterial, viral, or sometimes even non-infectious causes," Lakhani said. "Even vaping could sometimes appear this way." But the researchers also noticed that the ground-glass patches extend to the edges of the patient's lungs. "That's something we don't often see," Lakhani said. "We saw that with severe acute respiratory syndrome (SARS) and we saw that with Middle East respiratory syndrome (MERS)." Both SARS and MERS are also coronaviruses. An outbreak of the former in China resulted in 8,000 cases and 774 deaths from November 2002 to July 2003. Lakhani said scans of those viruses have "a lot of similar features" to the images from the 33-year-old patient. The scans show the virus getting worse after 3 days The researchers also saw that the white patches on the woman's lungs were more pronounced in the second image, taken three days after the first — and further into her treatment. That helps rule out the possibility of pneumonia. "Pneumonia usually doesn't rapidly progress," Lakhani said. "Typically, most hospitals will treat with antibiotics and patients will stabilize and then start to get better." In the hospital, the 33-year-old woman in Lanzhou inhaled a protein used to treat viral infections, called interferon. Lakhani guessed that doctors probably also administered "supportive treatment," such as fluids, steroids, or a medication to open the woman's airways. But she continued to get worse. That's significant, Lakhani said, since the same thing occurred in SARS patients. The best way to diagnose the coronavirus isn't via X-rays, though — it's a laboratory test, which involves taking swabs of saliva or mucus from a patient's nose and mouth or testing phlegm they may cough up. But the test isn't perfect, since it can only detect the virus when a person is showing symptoms. "We've seen people who had a detectable virus, then they didn't have a detectable virus, and then three days later they had a detectable virus," Robert Redfield, CDC director said in a briefing on Friday. "We don't know the natural history of how this virus is secreted." Read more about the coronavirus:
The Wuhan coronavirus has killed more than 200 people and infected at least 9,800. Here's everything we know about the outbreak. Here's what we know about the 7 confirmed US coronavirus cases. The Wuhan coronavirus seems to have a low fatality rate, and most patients make full recoveries. Experts reveal why it's causing panic anyway. The US will bar foreigners who have been to China within the past 14 days and quarantine some returning Americans Join the conversation about this story »
More like this (3)
Experts continue to study the novel coronavirus as the number of people it infects and kills...Experts continue to study the novel coronavirus as the number of people it infects and kills rises each day. Scientists are increasingly certain the coronavirus came from bats but aren't sure exactly how it hopped over to humans. Researchers also don't yet know why the virus doesn't cause symptoms in most children, whether it's seasonal, and how long people with antibodies might be immune. Visit Business Insider's homepage for more stories. In the realm of medicine, what you don't know can indeed kill you. When it comes to the novel coronavirus, technically known as SARS-CoV-2, and the disease it causes, called COVID-19, what experts are still trying to understand sometimes seems to outweigh what they can say for certain. That is little surprise to any infectious-disease researcher: Highly contagious diseases can move through communities much more quickly than the methodical pace of science can produce vital answers. What we do know is that the coronavirus apparently emerged in China as early as mid-November and has now reached more than 185 countries, infected more than 3.9 million people, and killed at least 272,000. Population-level studies using new testing could boost case numbers about 10-fold in the US. As hospitals around the world strain to care for patients with blood clots, strokes, and long-lasting pneumonia and respiratory failure, scientists are racing to study the coronavirus, spread life-saving information, and combat dangerous misunderstandings. Here are 11 of the biggest questions surrounding the coronavirus and COVID-19, and why answering each one is critically important.How did the new coronavirus get into people? The first coronavirus infections was thought to have emerged in a wet market in Wuhan, in China's Hubei province. But newer research suggests the market may simply have been a major spreading site. Researchers are fairly certain that the virus — a spiky ball roughly the size of a smoke particle — developed in bats. Lab tests show that it shares roughly 80% of its 30,000-letter genome with SARS (severe acute respiratory syndrome), a virus that also came from bats and triggered an epidemic in 2002 and 2003. It also shares about 96% of its genome with other coronaviruses in bats. Mounting evidence continues to undercut the conspiracy theory that the virus came from a Chinese laboratory, however. Still, researchers still aren't sure how the coronavirus made the jump from bats to humans. In the case of SARS, the weasel-like civet became an intermediate animal host. Researchers suspect that civets, pigs, snakes, or possibly pangolins — scaly nocturnal mammals often poached for the keratin in their scales — were a likely intermediary host for the new coronavirus. A research group in China published early, non-peer-previewed results that pointed to pangolins (which can die from coronaviruses) as the vector for humans, finding 99% genetic similarity. But it could also be that the virus jumped straight from bats to humans. Why it matters: Understanding how novel zoonotic diseases evolve and spread could lead to improved tracing of and treatments for new emerging diseases. How many people have actually gotten COVID-19? Global tallies of cases, deaths, recoveries, and active infections reflect only the confirmed numbers — researchers suspect the actual number of cases is far, far larger. For every person who tests positive for the novel coronavirus, there may be about 10 undetected cases. This is because testing capacity lags behind the pace of the disease, and many governments — including in the US — failed to implement widespread testing early on. Contrary to the claims of Elon Musk and others, deaths from COVID-19 are also likely being significantly undercounted. Why it matters: An accurate assessment is critical in helping researchers better understand the coronavirus' spread, COVID-19's mortality rate, the prevalence of asymptomatic carriers, and other factors. It would also give scientists a more accurate picture of the effects of social distancing, lockdowns, contact tracing, and quarantining. What makes the coronavirus so good at spreading? Setting aside any debate about whether they're alive (or something else), viruses are small and streamlined particles that have evolved to make many, many copies of themselves by hijacking living cells of a host. The measurement of a virus' ability to spread from one person to another is called R0, or R-naught. The higher the value, the greater the contagiousness — though it varies by region and setting. The novel coronavirus' average R0 is roughly 2.2, meaning one infected person, on average, spreads it to 2.2 people. But it had a whopping R0 of 5.7 in some densely populated regions early in the pandemic. The seasonal flu, by contrast, has an R0 of about 1.3. Researchers don't yet understand why the coronavirus is so effective at spreading, though they have some ideas. One is that its surface proteins, which enable the virus to stick to host cells and invade them, attach with an especially strong latch, The Atlantic's Ed Yong reported. The new coronavirus also seems to infect the upper and lower respiratory tracts, unlike SARS, which infected primarily tissue deeper in the lungs. And coughing — a signature symptom of COVID-19 — helps spread viruses in tiny droplets, especially in confined places. There's also some evidence the virus infects intestinal cells and may be spread by feces. Additionally, it's thought that 25% to 50% of people infected show few to no symptoms, helping facilitate the virus' spread. Why it matters: Knowing how a virus gets around can help everyone better prevent its spread. Getting a handle on its behavior may also spur governments to act sooner to contain future outbreaks of this or other similar diseases. What drives mortality in people infected by the coronavirus? People who develop severe COVID-19 symptoms follow a fairly regular pattern. On day one, the person often runs a fever and experiences muscle pain, fatigue, and a dry or unproductive cough. By day five their breathing is labored, and by day seven they may be hospitalized. Day eight is when the situation can turn dire, as fluid starts filling the lungs and blocking oxygen flow, a condition called acute respiratory distress syndrome. That fluid shows up with a telltale "ground glass" look on X-ray scans of the lungs. The pattern of critical cases is alarming to clinicians, and something they're still trying to grasp: It's not just people with apparent risk factors like smoking and chronic illnesses who get severely ill — it's also young and seemingly healthy people. The virus may replicate quickly enough to trigger the immune system very suddenly instead of gradually, causing it to go "berserk," a virologist told The Washington Post. In addition to damage caused by the virus, inflammation may further open up lung capillaries and cause them to leak more — causing fluid to quickly build up in the lungs, cut oxygen flow, and strain most organs in the body, including the heart, which must work harder. The virus also seems highly correlated with blood clots and strokes. It's not yet clear why, though one explanation is that the virus may be attacking blood cells. Neurological symptoms are also a seemingly common but poorly understood issue. Why it matters: Understanding how the coronavirus does so much harm could lead to more effective treatments in hospitals and make for promising drug targets. What percent of people infected by the coronavirus die? Death rates for COVID-19 are not one-size-fits-all. Many factors are at work. Age is a big one. Older generations are more likely to die as a result of lung failure, strokes, heart attacks, and other problems triggered by coronavirus infections, while younger generations are much less likely to do so. However, people of all ages, including children, have experienced severe symptoms and sometimes death. Government action matters greatly, too. In places that did not respond forcefully and early to the outbreak, emergency rooms and intensive-care units have been crushed with patients who require around-the-clock care. That can outstrip resources and force doctors to make life-or-death triage decisions. Even weather conditions may influence the virus' ability to spread, affecting the number of people it kills in a given population. Because the overall death rate is variable and ever changing, it won't get packaged into a reliable global average until the pandemic subsides. Why it matters: Variations in death rates help researchers expose flaws in government responses, supply chains, patient care, and more, ideally leading to fixes. However, the early data is clear enough: The coronavirus has the capacity to kill millions of people in a relatively short time. Why dp young people face the least risk of dying? On a per-capita basis, young people are the most resilient to the coronavirus. But they do get infected and suffer from it. As of March 16, nearly 30% of confirmed cases in the US were people between the ages of 20 to 44, according to the Centers for Disease Control and Prevention. That age category represented 20% of hospitalizations and 12% of ICU admissions. Even blood clots and strokes have emerged among younger patients in rare cases. Young people "are not invincible," Tedros Adhanom Ghebreyesus, the World Health Organization's director-general, said in a press conference in March. "This virus could put you in the hospital for weeks or even kill you." Typically, kids and older people are in the same risk category for diseases like the flu. But it's not so with COVID-19: About 80% of deaths have been people 65 and older, while only a handful of young children have died, possibly from Kawasaki disease brought on by infection. Very young children represent about 2% of cases. Why that's the case is one of the coronavirus' greatest mysteries so far. Some early and notional explanations from medical professionals interviewed by The Washington Post suggested it may have something to do with the virus causing older, more mature immune systems to overreact, yet have trouble attaching to surface receptors on the cells of young children. Why it matters: Understanding why kids don't often show signs of the disease — either because they're not as prone to infection or because they more often experience very mild, cold-like symptoms — could have huge ramifications for vaccine development and understanding how the disease spreads. Can you get reinfected? The body almost certainly develops short-term immunity in the form of antibodies, and immune-system researchers are reasonably confident that the body will recognize and fight the coronavirus in the future. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently told the "Daily Show" host Trevor Noah that he was "really confident" that recovered coronavirus patients would have immunity. Fauci said he'd be "willing to bet anything that people who recover are really protected against reinfection." There have been a small number of cases in which people tested positive for the coronavirus, were later found to be free of the virus, then tested positive again after that. But these cases are mostly the result of false positives and misinterpretations of test results, since some diagnostic tests can detect leftover pieces of dead virus in the body. Still, no one is certain about the prospects for long-term immunity, seeing as so little time has passed since the coronavirus emerged. Why it matters: Understanding whether long-term immunity is the norm would have major ramifications for controlling the pandemic and could enable officials to lift social-distancing restrictions for people who have already gotten sick. How seasonal is the coronavirus? President Donald Trump has said "a lot of people think that [the coronavirus] goes away in April, with the heat, as the heat comes in." That obviously has not happened, and most experts do not think the virus will simply vanish as summer temperatures arrive. Still, warmer and wetter conditions may at least hinder the virus' spread. Unpublished research by a team of scientists in Beijing found that "high temperature and high relative humidity significantly reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities." Why it matters: Knowing how much — if at all — the novel coronavirus is affected by changing seasons would help governments around the world better deploy resources to confine its spread. Are there any safe and effective drugs to treat COVID-19? There is, as of yet, no slam-dunk treatment for COVID-19 or its symptoms. However, candidates for effective drugs are actively being explored. Trump has promoted and sought stockpiles of hydroxychloroquine: a relatively inexpensive drug typically used to kill malarial parasites and treat lupus and rheumatoid arthritis. But it was found to have no significant benefits for COVID-19 patients. (At least one man died after mistaking a fish tank cleaner's ingredients for the drug hydroxychloroquine after Trump praised it.) A more promising drug is remdesivir, an experimental antiviral chemical that the FDA recently approved for emergency use. But hospitals are having trouble getting their hands on it. There is still ongoing research into remdesivir's efficacy and safety for people with COVID-19, as is true with a dozen other treatments. Why it matters: Having tools to slow infections or perhaps even stop the coronavirus from harming people could curtail its spread, reduce suffering, ease the burdens on healthcare systems, and save lives. Will there be a vaccine for the coronavirus, and when? At least 100 coronavirus vaccines are in development. They each take different approaches — though some are only slightly different — and there's a good chance that at least one will work safely and effectively. All the vaccine candidates are in an early experimental phase, though. It may take more than a year to prove they work and another six months after that to manufacture and distribute them. Unfortunately, there's also no guarantee that any of them will work or be produced in record-breaking time. In the meantime, social distancing — staying at least 6 feet away from people outside your home — may be the new normal for months if not years. Why it matters: Developing a vaccine would help the world put an end to the pandemic. What are the long-term consequences for those who survive COVID-19? Some of the first people who got the coronavirus and recovered have been well for only a few weeks. So it's not yet clear what the long-term consequences of weathering a severe bout of COVID-19 might be. One emerging story from early cases in China is reduced lung function. Some survivors "gasp if they walk a bit more quickly," a top infectious-diseases expert said, according to the South China Morning Post. He added that "some patients might have around a drop of 20% to 30% in lung function." Patients who experience blood clots also face a risk of longer-term damage, pain, and loss of function, especially in organs. It's also still unclear how long symptoms can linger. Some people have told Business Insider that, many weeks after getting infected, they still experience fatigue, diarrhea, headache, loss of taste and smell, or other pernicious symptoms. Why it matters: If the coronavirus is found to cause lasting damage to lungs and other organs, governments should prepare for long-term strain on healthcare systems, impacts to the workforce, and slower economic recoveries. They should also push for more research into the underlying causes of lingering symptoms and effective treatments for them. Bill Bostock, Andrew Dunn, and Holly Secon contributed reporting to this article. This story was originally published on March 30, 2020. It has been updated with new information.
More than 1.3 million people have recovered from the coronavirus — and are likely now immune. But painful symptoms may last far longer than people realize.
More than 1.3 million people worldwide have recovered from the coronavirus. Recovered COVID-19 patients may have...More than 1.3 million people worldwide have recovered from the coronavirus. Recovered COVID-19 patients may have a residual cough or fatigue for weeks after major symptoms disappear. Though long-term effects remain unclear, patients who develop severe pneumonia could come away with scarred lungs and reduced lung function. Recovery likely means immunity, at least for a period of time, so people who were once infected could go back to work with low risk of reinfection. Visit Business Insider's homepage for more stories. Most people who get the coronavirus recover. More than 1.3 million such cases have been documented worldwide. "Eventually, if all goes well, your immune system will completely destroy all of the virus in your system," Tom Duszynski, director of epidemiology education at Indiana University–Purdue University Indianapolis, wrote in The Conversation. "A person who was infected with and survived a virus with no long-term health effects or disabilities has 'recovered.'" Still, many uncertainties remain: It's not yet clear how many people have recovered, how the illness will affect them in the long run, or how long they'll be immune. The process can take much more time and pain than people realize. Here's what the research so far reveals about people who have recovered from COVID-19. Recovery by the numbers Although more than 1.3 million people who had the coronavirus have recovered worldwide, according to Worldometer, the true number is probably far higher. Data on recoveries is less precise than case counts and death tolls, and many counties, states, territories, and regions don't report how many of their residents have recovered. "Recovered cases outside China are country-level estimates based on local media reports and may be substantially lower than the true number," Douglas Donovan, a spokesman for Johns Hopkins University, which previously tracked global recoveries in its COVID-19 database, told CNN. Plus, due to limited testing availability in some countries (including the US), the most severe cases were initially prioritized for official diagnoses. People who had mild symptoms, or none at all, have been less likely to get tested — if they even seek testing in the first place. That means that many mild infections are not included in the count of total cases or recoveries. That can skew experts' understanding of the disease and how they predict its trajectory. "Knowing the real number of infected people in the population would be very useful to have better models of when disease will peak and decline, and also when we can begin to return people to work," Dr. Bala Hota, a professor of infectious diseases and Associate Chief Medical Officer at Chicago's Rush University Medical Center, told CNN. What recovery is like Recovery doesn't necessarily mean feeling all better. Hota told CNN that many patients still have a mild cough and feel tired even once they're considered recovered and are no longer contagious. It can take a long time to fully get back to normal. "It takes anything up to six weeks to recover from this disease," Dr. Mike Ryan, executive director of the World Health Organization's Health Emergencies Program, said in March. "People who suffer very severe illness can take months to recover from the illness." The process is different for patients who were put on a ventilator. "What we're seeing in patients who end up on ventilators is that they often stay on them for several weeks," Dr. J. Randall Curtis, a professor at the University of Washington Harborview Medical Center, told US News & World Report. "And then, coming off the ventilator, they're often going to be in the ICU for several days, and then back [in a regular hospital unit] for a few days to a week or so to regain their strength." People who were put on a ventilator can walk away with long-term physical and psychological damage. If they develop acute respiratory distress syndrome (ARDS), that can scar their lung tissue. Lasting effects Dr. Shu-Yuan Xiao, a pathology professor at the University of Chicago School of Medicine, told ABC News that most people with mild cases of COVID-19 should recover "with no lasting effect." The future is murkier for patients who develop severe illness, though. Hong Kong's Hospital Authority reported in March that within a group of 12 recovered patients, "two to three" showed decreased lung capacity in follow-up visits with doctors. Those few patients gasped for air when they walked, according to the South China Morning Post. Scans of nine patients' lungs revealed signs of organ damage. But because the coronavirus was first identified in December, there hasn't been much time to research recovered patients and publish the findings. "This is a little bit of an understudied group," Hota said. Experts do have a sense of the effects that severe pneumonia can have on the body, though. If a patient develops acute respiratory distress syndrome (ARDS), that can scar their lung tissue. "It's the same general thing that you have with any type of phenomena that's severe enough to land you in the ICU," Dr. Amesh Adalja, an infectious-disease expert at the Johns Hopkins Center for Health Security, told ABC News. Adalja and Xiao both said that some severely ill patients may never recover full lung function. Antibodies and immunity People who have been infected develop antibodies that can probably fight off the coronavirus if they encounter it again. A pre-print study published Tuesday reported the results of 1,300 antibody tests from people who had confirmed and suspected cases of COVID-19 in and around New York City. The findings showed that 99.8% of people who got a positive diagnostic test later got positive results for antibodies. The research countered fears that not all patients walk away with antibodies. One Chinese study, which has also not yet been peer-reviewed, tested 175 recovered COVID-19 patients and found that 10 of them had not developed any detectable coronavirus antibodies. Antibody tests can sometimes return false negatives as well as false positives. But proponents of antibody testing say that it's imperative in the fight against the outbreak, since immune people could return to work safely. "Ultimately, this might help us figure out who can get the country back to normal," Florian Krammer, a professor in vaccinology at Mount Sinai's Icahn School of Medicine, told Reuters. "People who are immune could be the first people to go back to normal life and start everything up again." Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview on "The Daily Show" that he was "willing to bet anything that people who recover are really protected against reinfection." "What we don't know yet is how long that immunity will last, the quality of that immunity, and whether all individuals will generate a long-lasting high immune response," Frances Lund, chair of the microbiology department at the University of Alabama at Birmingham, previously told Business Insider. Fauci also said on April 8 that because the virus doesn't seem to be mutating much, people who recover will likely be immune should the US see a second wave of spread in the fall. "If we get infected in February and March and recover, next September, October, that person who's infected — I believe — is going to be protected," he said. Although China, South Korea, and Japan have all reported rare instances in which people who recovered from the coronavirus later tested positive, those cases were probably the result of false positives, experts say. When you can leave self-quarantine If you're sick and wondering how to know when you've recovered, CDC guidelines depend on whether or not you were tested. If you weren't tested and probably won't be, you should stay isolated until you meet three criteria: You've have had no fever for at least 72 hours (without fever-reducing medication), your other symptoms (such as shortness of breath or coughing) have improved, and at least ten days have passed since the onset of symptoms. If you have gotten or will receive a diagnostic test, you need to test negative twice, 24 hours apart, before leaving isolation. Those tests must be done after you no longer have a fever (without fever-reducing medicine) and after other symptoms have improved. Once you have met these criteria, you can leave your home for essential outings, in accordance with your city, county, and state rules. You should still minimize contact with others, though, as well as disinfect all surfaces, clothes, and objects you've touched. Scientists still aren't sure when a person with the virus stops being contagious to others, but a team of German researchers found that coronavirus patients "shed" high amounts of virus early on in their infection. (The research is not peer-reviewed yet, however.) In mild cases, the amount of the virus the gets shed decreased significantly after day five. Patients with mild cases were not infectious eight days after they first started experiencing symptoms. The serious cases were not infectious after day 10 or 11. Holly Secon contributed reporting.Join the conversation about this story » NOW WATCH: How to help hospitals and healthcare workers fighting the coronavirus
Mysterious strokes among young COVID-19 patients may reveal how 'a virus can cause strokes in ways we never knew before,' a doctor says
New York City doctors have reported a handful of young patients with mild coronavirus cases who...New York City doctors have reported a handful of young patients with mild coronavirus cases who experienced large-vessel strokes. The patients were at low risk for strokes, a new report reveals. Such strokes occur when a blood clot travels from the body into an artery in the brain. Experts have reported blood clots in patients with severe COVID-19 cases. One of the doctors behind the report told Business Insider that stroke-causing clots may be a result of coronavirus-induced swelling in blood vessels. Visit Business Insider's homepage for more stories. Four people in their 30s and 40s were recently admitted to Mount Sinai Hospital in New York City with life-threatening strokes. Their cases were united by a common theme: All of them had COVID-19. "Large-vessel strokes in young patients are exceedingly rare," Thomas Oxley, a neurosurgeon at Mount Sinai who published a new report about the cases, told Business Insider. "They'd need a past history concerning strokes. But these patients had minimal past medical histories and all came in within two weeks." The patients, four men and one woman, were hospitalized between March 23 and April 7. In Oxley's paper, published Wednesday in the New England Journal of Medicine, he and his colleagues wrote that "every two weeks over the previous 12 months, our service has treated, on average, 0.73 patients younger than 50 years of age with large-vessel stroke." So the recent handful of stroke cases stood out. "What if we're now learning that a virus can cause strokes in ways we never knew before?" Oxley said. The young stroke patients had mild or no COVID-19 symptoms Large-vessel strokes are caused by a blood clot that travels from the body into an artery in the brain. The new report describes how this happened in each of the five recent New York cases. The only woman in the study, a 33-year-old, had no prior medical history, the paper says. She experienced a COVID-19-related cough, headache, and chills in the week prior to her stroke. Then, over a period of 28 hours, her speech became slow and slurred as her jaw muscles shut down. Her left arm and leg became weak and numb. At Mount Sinai, Oxley and his colleagues found a blood clot in her brain's carotid artery. They used a "clot-busting" drug to break it up over the next 10 days. The four male patients, meanwhile, had similar stories. All of them experienced numbness, slowed speech, and temporary paralysis before they went to the hospital, where doctors removed the life-threatening clots. The men ranged in age from 37 to 49; two had mild coronavirus symptoms while the other two reported none at all. Only one had suffered a stroke before. 'Dumbfounded' by the link between COVID-19 and strokes Oxley said that since first speaking out about these stroke cases, he's been flooded with emails from other coronavirus patients describing minor strokes. A 31-year-old man messaged him on Sunday, describing a sudden onset of speech disturbance and numbness, Oxley said. The patient went to the hospital, and an MRI revealed he'd had a stroke in his thalamus. "I was just dumbfounded by this story of a patient who had never had a past history of stroke," Oxley said. He added that strokes have also been observed in older COVID-19 patients, but the new trend is reason for additional concern because it involves people in their 30s and 40s without severe symptoms. (Overall, nearly three-quarters of all strokes occur in people over the age of 65.) Oxley and J. Mocco, another Mount Sinai neurosurgeon, think the link between COVID-19 and the increase in strokes they're seeing has to do with blood clots. Experts have reported blood clots appearing in various parts of coronavirus patients' bodies, including the lungs. Broadway actor Nick Cordero, who was diagnosed with coronavirus, had to have his right leg amputated after clots formed. "It's very striking how much this disease causes clots to form," Mocco told Reuters. Coronaviruses in general have also been known to cause neurological issues like strokes, according to a February study. Roughly 2% of patients in Singapore who contracted SARS (also a coronavirus) had strokes. A study on COVID-19 patients at three hospitals in Wuhan, China — which is not yet peer-reviewed — found that of 214 patients, 36% had neurological symptoms. That included impaired consciousness and acute cerebrovascular diseases like strokes. The coronavirus might attack both the lungs and the blood Scientists aren't yet sure why COVID-19 causes clots, but Oxley said they might be the result of blood vessels' reaction to being invaded by the virus. The new coronavirus attacks via a specific cell receptor called ACE2, which can be found throughout the body, including in our guts, lungs, hearts, and even noses. According to Oxley, the virus can also bind to ACE2 receptors in the walls of our blood vessels. That leads the vessels to become inflamed, which can cause clotting. Then once a clot has formed, it can travel to the brain and cause a stroke. Not everyone's blood-vessel walls have the same level of ACE2 receptors, though. That characteristic is linked to a patient's genetics, rather than their age, Oxley said. That might explain why blood clots appear in patients across age brackets. Oxley said COVID-19 is teaching his colleagues about a previously unexplored link between viruses, inflammation, and strokes. "There are other viruses we're going to learn about in the future that may be connected to strokes in the same way," he said.SEE ALSO: 5 young New Yorkers with mild COVID-19 cases were recently hospitalized with strokes. Doctors say the coronavirus can cause blood clots. Join the conversation about this story » NOW WATCH: Alarming videos from hospitals around the world show what doctors are facing as they treat coronavirus patients