PHOENIX — While Riley Behrens laid in a hospital bed hooked up to tubes and wires, he opened his Twitter to find that his story had gone viral overnight.
“Not taking this pandemic seriously? Keep reading,” the 23-year-old Tempe man wrote Sunday evening in a thread detailing five days of worsening illness. It had reached nearly 150,000 likes and 45,000 retweets by Tuesday afternoon.
Parents replied to the tweets that they would show them to their older children, who were still going out with friends unmasked. Some shared kind words and sympathies.
Behrens was most surprised to see, though, that there were other people in their early 20s commenting how they had experienced the same symptom after contracting COVID-19 that he had — a mild stroke.
A week ago, Behrens had no idea that young people all over the world were having TIAs, or transient ischemic attacks, as complications of the novel coronavirus.
Several studies, including one from the Barrow Neurological Institute in Phoenix, have shown evidence of neurological complications of COVID-19 in people who have no risk factors for them and who are otherwise mildly symptomatic.
“I never heard that this was a thing, I never heard of other people having it,” Behrens told The Arizona Republic, part of the USA TODAY Network, on Tuesday. “You say stroke, and I think, ‘Grandpa, Grandma can have a stroke, not me.’ There’s just no way.”
But on Wednesday evening, the 23-year-old went to bed with a headache. Three days later, he was admitted to the hospital. He knew something was wrong, but he never expected a brain injury.
Earlier today, I was diagnosed as having suffered a Transient Ischemic Attack (TIA), or what’s commonly known as a mini-stroke. I’m 23 years old and I just had a stroke due to Covid-19 complications.
Not taking this pandemic seriously? Keep reading.
— Riley Behrens (@RileyBehrens) November 30, 2020
‘I’m 23, this isn’t happening’
Ahead of his trip home to the San Francisco Bay Area planned for Thanksgiving, Behrens said that he made sure to quarantine for two weeks in his apartment in Tempe, Ariz. His father is immunocompromised.
When his friend lost housing, Behrens offered him a place to crash on the condition that he was being careful to follow health precautions.
The two got tested the Sunday ahead of Behrens’s trip. On Wednesday, their results came back: positive for SARS-CoV-2, the virus that causes COVID-19.
Before coming to stay, Behrens’s friend had gone to a family wedding and was exposed.
Behrens got a headache that night that he assumed was just stress. Thursday, he started to have trouble breathing and pain in his chest. It worsened on Friday.
On Saturday, he woke up with extreme weakness in his left side. He couldn’t balance on his left leg or open the door with his left hand. He was dizzy. His vision was also spotty through his left eye. Both his father and doctor told him to get to the hospital immediately.
Riley Behrens, 23, sits in his hospital bed at Chandler Regional Medical Center after a TIA, or a mild stroke, on Nov. 29, 2020.
The doctors suspected a stroke, but at that time, Behrens couldn’t believe it.
“That was a surprise, because I didn’t really know the stroke symptoms. Honestly, when I hear the word ‘stroke,’ I think of people my dad’s age. My dad is 62,” Behrens said.
Behrens was admitted for the night. An MRI the next morning showed that he had a TIA, or a mild blood clot in the brain.
Over the next two days, he said he had several tests, screens and injections. He was finally released Monday with an array of medical appointments scheduled over the next several days.
Behrens said that his only preexisting condition is exercise-induced asthma, which had mostly resolved by middle school.
As of Tuesday, Behrens, a student at Harvard and former semi-professional rugby athlete, was still experiencing some symptoms, including dizziness and exhaustion. He also has new restrictions on his lifestyle.
“I’m not walking my dog on long walks,” Behrens said. “I’m not over-exerting myself cleaning my house. I’m not allowed to drive until I’m cleared by a neurologist. I can’t play sports because the risk of another head injury increases the risk of a stroke.”
Some things are still too strenuous for the former athlete.
“You never imagine at 23 that you get tired just walking a dog,” he said. “I don’t want to admit that I can’t do this stuff. It’s really hard.”
Neurological complications of COVID-19
Behrens isn’t sure what to expect now. Typically, TIAs resolve quickly and do not cause permanent damage, according to the Mayo Clinic.
However, about one in three people who have a TIA will eventually have a stroke, and half of those people will have one within a year.
Dr. Luay Shayya, a neurologist with Neurology Consultants of Arizona, said that Behrens’ case is not isolated. Shayya has not treated Behrens but spoke about the disease generally.
Doctors initially thought COVID-19 was primarily a respiratory illness, but as the virus spread, they learned that many patients were also experiencing neurological symptoms — “COVID-brain, if you will,” Shayya said.
Loss of taste and smell is an example of a neurological symptom, as the virus affects sensory pathways to the brain, Shayya explained. Strokes are a more obvious neurological symptom.
“There have been multiple case reports published … about patients who are young having large strokes due to COVID,” Shayya said, although he has not treated a case himself. “It’s very unusual for young people to have strokes to begin with.”
One explanation for why this happens is that COVID-19 is causing blood clots to form that then travel up to the brain, Shayya said.
With some rehabilitation and therapy, young people generally have a good prognosis for recovery after a TIA.
More: The young die as well from COVID-19, even as many engage in denial
Road ahead: Why this Harvard doctor is optimistic about US overcoming COVID-19 despite ‘epidemic of mistrust’
Young people need to ‘wake up’
Behrens struggled to find the words to describe the virus that hospitalized him. Finally, he settled on “unpredictable.”
This sickness, he said, does not discriminate. It can affect people in ways we still know little about.
That was why he decided to tweet about his experience from his hospital room. He wanted to show other young people that severe complications can happen to them, too.
As Arizona’s cases begin to surge again, the majority of new infections are in people between ages 20 to 44. Most hospitalizations are in people 65 years or older.
“They literally shot blood thinners into my stomach because it was working faster than pills were. That’s not something I ever want anyone to go through,” he said.
“Wake up,” he said. “This is real, and you need to start paying attention.”
Follow Emily Wilder on Twitter @vv1lder.
This article originally appeared on Arizona Republic: COVID complications: Arizona man goes viral after mild stroke