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Stroke history may explain why Black people are more likely to die of COVID, study says

The findings add to several other racial disparities among COVID-19 outcomes that have unearthed since the pandemic began.
Black COVID-19 patients are more likely to have experienced strokes prior to their diagnosis than their non-Black counterparts, according to a study by Penn State College of Medicine researchers. They said this may be one explanation for why COVID-19 mortality has been high in Black populations. (Xixinxing Getty Images | iStockphoto via Penn State)

Since the pandemic began, communities of colors have faced the highest risks of severe COVID-19 outcomes, including hospitalization and death.

Now, a new study says history of stroke — a known risk factor for coronavirus-related death — may be one reason that explains why Black people, in particular, have greater likelihoods of dying from the disease than people of other races and ethnicities.

An analysis of nearly 9,000 hospitalized adults with COVID-19 found that Black patients were three times more likely to have had a stroke before contracting the coronavirus than non-Black patients, even after researchers accounted for other risk factors for stroke, including age, sex, diabetes, obesity, high blood pressure, alcohol intake and history of smoking.

The study does not, however, mean that stroke causes COVID-19 or death from it.

The findings align with other data that shows Black people are nearly twice as likely to have a stroke compared to white people, and the most likely to die from it.

“Historically, stroke rates have been consistently higher among the Black population,” Dr. Paddy Ssentongo, assistant research professor at Penn State Center for Neural Engineering, said in a statement. “However, we did not expect this very high racial disparity in stroke prevalence among patients with COVID-19.”

Study participants were admitted to hospitals for COVID-19 across 35 states between December 2019 to August 2020; 30% of the patients were white, 36% Hispanic and 34% Black.

Among 8,815 patients in the study, 77 had a history of ischemic stroke, which is when oxygen fails to reach the brain because of restricted blood flow. The majority of those patients were Black (50%), followed by white people (29%) and Hispanic people (21%).

Some reasons why Black people have been among the hardest hit by the pandemic lie in their working and living conditions. Black people are more likely to live and work in crowded spaces that could expose them to the virus. They are also more likely to have chronic health conditions. A history of racial discrimination in medicine may also explain why some Black people prefer to avoid medical attention when they are severely ill.

The Centers for Disease Control and Prevention says someone in the U.S. has a stroke every 40 seconds, with deaths occurring every four minutes. More than 795,000 Americans have a stroke each year, with about 610,000 of them being first or new strokes.

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