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Severe Coronavirus Cases Presenting With Blood Clots

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You are being bombarded with coronavirus news every day. The information is confusing and recommendations from the experts seem to change week to week. You, a loved one or an acquaintance may have fallen ill with COVID-19. It is natural to be concerned and to look for answers. It is not good that any of us live in fear. At VSS we want to be a trusted resource helping you in your journey so that you can enjoy life again with family, friends and your vocation.

There is still much to learn about the novel coronavirus, COVID-19. Doctors have noticed an increased incidence of blood clots in patients with severe coronavirus. These blood clots are seen in the lungs, heart, kidneys and elsewhere throughout the body. This observation led research physicians around the world to study the link between COVID-19 and blood clots. Recently published articles break down some theories that may explain these phenomena. While these studies are ongoing we look forward to seeing how clinical advances in treatment that can significantly lower or eliminate complications in COVID-19 patients.

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For years we have known an illness requiring hospitalization and or long periods of bed rest increases the risk of blood clots forming in the leg, a condition known as Deep Vein Thrombosis (DVT). When a DVT forms, there are several concerns. If the clot breaks free it can travel to your lungs creating a life threatening Pulmonary Embolism (PE). If the clot in the leg blocks most or all of the venous blood returning to the heart there is a risk of limb loss unless it is treated quickly. Long term a significant number of patients can develop chronic swelling, skin changes, pain and ulcers on the legs. This is called Post Phlebitis (DVT) Syndrome. As with many illnesses, the best treatment for this condition is prevention of blood clots when possible and early diagnosis and treatment when not.

In severe coronavirus cases, however, doctors have noticed higher than usual incidents of blood clots compared to the seasonal flu. These clots in the lungs, heart, and kidneys contribute to pulmonary embolism, heart attacks, kidney failure, and strokes. As you recover from COVID-19, these chronic health conditions require additional examination and treatments slowing the recovery process.

 

What Doctors Have Seen in Severe Coronavirus Cases So Far

As of August 2020, this is what we have learned.

Strokes

Researchers in JAMA Neurology found that the risk of stroke is seven times higher in coronavirus cases than in patients being seen for seasonal flu. This has led emergency room physicians to consider immediately prescribing blood thinners to COVID-19 patients in higher doses to treat and prevent blood clots.

Yale neurology professor, Dr. Sharon Stoll, also expressed concerns about coronavirus cases showing increased incidence of blood clots in the legs and heart, even in young, healthy patients with no comorbidities. She said thirty percent of COVID patients present with neurological symptoms like confusion, loss of smell and taste, or a stroke.

Deep Vein Thrombosis and Pulmonary Embolism

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A Radiology study showed that some COVID-19 patients who have blood clots in the legs have a higher rate of amputation and death compared to patients who have DVT alone without COVID-19. For this reason researchers are urging physicians to be on the lookout for DVT in their COVID patients. Signs of severe obstruction by clots, according to a letter published in JAMA Dermatology, are skin discoloration, rashes, and uneven lesions, which are dark red or dark purple. This is caused by red blood cells “leaking” into the skin.

As stated previously, DVT is also a risk factor for PE, a life threatening emergency condition. When the blood clot breaks free in the leg and travels to a lung, blocking the free flow of blood from the heart into the lungs where carbon dioxide is exchanged for oxygen. COVID-19 patients already are having a difficult time breathing and this only makes it worse. Remember the signs of PE include difficulty breathing, chest tightness or heaviness, and a feeling of impending doom. If you suspect a PE, call 911. Ask your doctor, “how do you know this is not a PE?”

Cardiovascular Disease and Heart Conditions

For patients with underlying cardiovascular conditions or high blood pressure, the rate of hospitalization with novel coronavirus is six times higher than someone without an underlying health condition. As doctors observe more cases, they have learned that severe coronavirus cases present with an immune response causing hyperinflammation and blood clots. These clots can lead to both heart attacks and strokes.

Why are Blood Clots Formed in Severe Coronavirus Cases?

Understanding that the information is still relatively new, with researchers learning more every day, we have begun to find answers to this question.

Due to the high rate of clots forming in COVID-19 patients when compared to patients with other viruses, researchers understood that there had to be a specific cause or set of contributing factors. What researchers in Munich, Germany, recently discovered is that blood clots found in the heart, lungs, and kidneys are likely caused by immunothrombosis, as the clots were primarily made up of platelets and activated immune cells. Essentially, clots are formed due to the body’s heightened immune response to the virus.

Activated immune cells are deployed by the immune system to trap and destroy bacterial and viral pathogens. While this is a good thing, it can also lead to the formation of blood clots.

What This Means for Patients Who Recover

Doctors are seeing recovered coronavirus patients who still present with symptoms related to blood clots formed during their illness. In fact, many physicians expect to see a surge in kidney disease for a generation. Some patients have difficulty resuming daily life and may not even be able to return home immediately after being discharged from the hospital. Many physicians treating severe coronavirus cases are calling for long-term care following recovery from the virus. Some patients require supplemental oxygen. Lack of activity also leads to other concerns, such as additional blood clots and loss of muscle mass.

What This Means for the Public

If you are high-risk, take precautions recommended by your doctor and health officials, including social distancing, masks, and hygiene. It’s also important to keep appointments with your doctors and take your medications as prescribed, unless otherwise instructed. It is equally important, however, to maintain a healthy lifestyle which includes exercise, fresh air, and sunshine. If you are exposed to high-risk people, it’s important to follow guidelines to protect those you love or who are in your care.

Most importantly, as we learn more about this virus, we are better able to treat the illness and prevent severe complications. So we will end on this note — there is reason to be hopeful. This information is already being used to help patients currently in the hospital. Remain cautious, but be hopeful.

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Venous Disease Support at Vein Specialists of the South

There is still so much we don’t know about novel coronavirus. However, news of venous symptoms and the link between severe coronavirus cases and blood clots is important to the ongoing care our team may need to provide to patients who recover from COVID-19. Our team of vein specialists are leaders in venous disease education, evaluation, and treatment in the United States. Our providers educate and lecture to other providers in cutting edge technologies and innovations in prevention, evaluation, and treatment of venous disease, including blood clots, varicose veins, and lymphedema.

Click here to find out more or book an appointment at one of our Georgia vein clinic locations.

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