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Faculty of Science

Biology Alumnus Represents Canada in North American Research Linking COVID-19 to Stroke

By Clara Wong

Adam Dmytriw

Back in spring 2009, Adam Dmytriw wrapped up his undergraduate days at Ryerson with a degree in science. Just over a decade later, he’s now a radiologist and the Canadian Lead for the North American Neurovascular COVID-19 Consortium.

Within the consortium, Dmytriw has been investigating a suspicious increase in strokes among patients with COVID-19. Their findings have garnered attention from the New York Times, Globe & Mail, Euronews and media outlets around the globe.

After Ryerson, Dmytriw completed master’s degrees at Oxford and Harvard in Immunology and Epidemiology respectively, a medical degree at Dalhousie, and residency at the University of Toronto. His next stop: a Clinical Fellowship in Neuroradiology & Intervention at the world-renowned Brigham and Women’s Hospital in Boston. We recently spoke to Dmytriw about the COVID-stroke connection, his career path, and Ryerson’s impact on his journey.

We know COVID-19 attacks the lungs. Is it causing strokes now too?

Early on, we began seeing increased reports of stroke patients who were under 50 with no known risk factors, but what they had in common was a COVID infection. So we started a consortium to investigate. Our initial study looked at reports from four hospitals in New York but has since grown to comprise other sites in North America which have been affected. But there are similar findings around the world. For example, our colleagues and another health system in New York both reported five or more cases of COVID-positive large-vessel strokes in a single week (these are massive strokes of the main arteries of the brain). Before COVID, a rate like this in young patients was essentially unheard of.

Newspapers feature the study’s younger stroke victims. Are they the majority?

No, but there’s still a disproportionate number. In our study, the median age was 58. Normally, it’s closer to 75. What’s worrisome is that the younger COVID-positive patients tended to have these massive large-vessel strokes.

Have doctors discovered the cause yet?

Profoundly ill patients in ICU are more prone to clot, but we suspected early that something else was going on here. It seems the virus can directly attack the inner wall of blood vessels, which causes massive clotting and elevated clotting proteins in the blood. Our consortium was one of the first to propose this in pre-print studies, and it is now becoming more apparent in lung pathologic studies.

The findings sound scary. How big is the actual risk?

Overall, it’s rare. If a patient is hospitalized for COVID, they have a 1.3% chance of stroke according to the international arm to which we are contributing. While it may take some time before we are confident about the incidence as we gather more data, the public at large doesn’t need to be overly worried. We haven’t seen any cases in Toronto at all over the same period.

What takeaways should the public know?

No one should ever avoid seeking hospital care if they have stroke symptoms. The benefits of going greatly outweigh any chance of contracting COVID. If you’re young, with no obvious risk factors, don’t ignore the signs, thinking “I’m too young to have a stroke”. Strokes can kill brain cells within minutes. But with medical attention, many cases are treatable to some extent, and that seems true in our COVID series as well.

You’ve done fantastic work. What role did Ryerson play in your journey?

I’m so proud to have gone to Ryerson. A wonderful thing about the university is the barrier-free culture. In many institutions of higher learning, lecture halls are quiet. Students are afraid to get things wrong or be judged for a question they have. It’s such a shame. But Ryerson professors are very receptive to inquisitive minds. It’s a wonderful environment to share ideas and be intellectually curious. Dr. Mario Estable, my research supervisor, embodied that philosophy. He could see the potential in anyone and bring out the best in them. My work with him in microbiology and virology really set me down my career path.

Any fond memories from your undergraduate days?

I have so many lovely memories... Playing squash at the RAC and ending up in the best shape of my life is a favourite. The camaraderie of volunteering as a science mentor in Toronto community centers is something I think about often. One time, Dr. Anne Johnson, my organic chemistry professor, who plays cello, gave our class a private recital. That was so special, and speaks volumes about the Ryerson atmosphere.

You’re a busy doctor and researcher. What’s on the horizon?

I enjoy research to the point where it often feels like play. People often say this is the sign you have found your passion, so that’s encouraging. Sometimes in grad school, you wonder: Is my research scope too narrow? Does anyone even read it? But through social networks like ResearchGate, I hear practitioners in Brazil, Japan and other countries directly saying my work improved the way they treat patients. Hopefully making the world a better place through clinical research is incredibly rewarding!