COVID-19 Virus Can Cause Blood Clots in Critically Ill Patients

More and more doctors are seeing blood clots in their critically ill Covid-19 patients.  Some COVID-19 patients develop an abnormal coagulation disorder. This blood-clotting disorder has led to complications such as heart attacks, strokes, and amputations.

Blood Cells

Red Blood Cells

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Every day we learn a little more about the dark consequences of the novel coronavirus. Originally understood as a virulent respiratory disease, it was discovered that the disease can also affect other organs, such as the kidneys, digestive system, eyes, and heart.

Excessive Blood Clotting

Recently, researchers discovered that SARS-CoV-2 can lead to the formation of blood clots in the blood vessels of patients. A Dutch study published in Thrombosis Research reports that 38% of 184 patients with COVID-19 had blood that was abnormally clotted. Similar findings were reported in the U.S during autopsy. An examination of  COVID-19 patients’ lungs revealed excessive clotts.

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Consequences of Excessive Blood Clotting

Blood vessel clots can have serious consequences. When they form in the veins of the legs, they can travel to the lungs, block the arteries, and cause a pulmonary embolism. They can also cause a heart attack or a stroke. More and more doctors around the world are observing these cases among COVID-19 patients. Dr. Jeanne Marrazzo, Professor of Infectious Diseases at the University of Alabama in Birmingham, believes that micro clumps can also be responsible for one of the unique symptoms of COVID-19: the sudden loss of smell.

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In the United States, doctors first noticed abnormalities in the legs of their patients, which swelled and turned blue. Several American intensive care units noticed many similar cases at the same time. The phenomenon was so severe to point of clogging -up dialysis machines used on these patients.

At NYU Langone, New York City lung specialist Shari Brosnahan is currently monitoring two people in their 40s in intensive care. One of them is in danger of losing a hand and the other the four limbs. The number of cases in which clots return to the veins has more than doubled since the beginning of the epidemic in critically ill patients, she told AFP.

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Every year doctors treat patients with coagulation complications and “they don’t clot like this,” said Dr. Lewis Kaplan, a physician at the University of Pennsylvania and director of the American Society of Critical Care Medicine, “The problem we have is that while we understand that a clot exists, we still don’t understand why it does. We just don’t know, that’s why we’re scared,” he told the Washington Post.

What Is the Treatment?

Anticoagulants such as heparin may be used to prevent excessive clotting. This practice does not always work, however, and sometimes leads to internal bleeding. SARS-CoV-2 clots are often micro-clots that form even in capillaries, the smallest blood vessels in the body. In this case, surgery is impossible and amputation is often the only solution.

This formation of microclotting could sometimes explain why artificial respirators are sometimes ineffective. This is because when they form in the lungs, blood cannot circulate in the lungs and leaves the body without oxygen.

Why Does This Occur?

Researchers are now working to understand why and how the virus would cause this clotting. This could be because many critically ill patients have a history of cardiovascular or lung disease. Inflammation associated with infection may yet be another cause.

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“One theory suggests that once the body is involved in a fight against an invader in this way, the body begins to consume clotting factors, which can lead to either blood clots or bleeding. In the case of Ebola, the balance was more in favor of bleeding. Covid-19 causes more blood clots,” says Harlan Krumholz, a cardiologist at Yale-New Haven Hospital in the USA.

But “any acute disease in itself is predisposed to the formation of blood clots,” said Behnood Bikdeli, an internal medicine specialist at Columbia University Medical Center (USA), in an interview with AFP. Moreover, “viruses often do strange things,” comments Shari Brosnahan. We are just discovering the strange things this virus produces”. Finally, while the variety of complications associated with Covid-19 is staggering, research on this new virus is still in its infancy. “It is possible that everything is caused by one thing and that there is a single solution,” concludes Shari Brosnahan.

References

https://www.thrombosisresearch.com/article/S0049-3848(20)30120-1/pdf

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