People with coronavirus are at risk of blood clots and strokes

In addition to causing serious respiratory problems, there is growing evidence that COVID-19 causes abnormal blood coagulation. Patients with severe COVID-19 infections appear to be at increased risk of developing blood clots in veins and arteries.

Thrombus develops deep in the veins of the lower extremities (deep vein thrombosis) and travels to the lungs, causing pulmonary embolism, limiting blood flow and oxygen, and potentially fatal.

A blood clot in an artery can cause a heart attack when the blood supply to the heart is cut off, and a stroke when the oxygen supply to the brain is cut off.

So what’s happening in the body of people with coronaviruses? And what are clinicians doing to treat or prevent this complication?

What do these blood clots do?

Recent data from Netherlands And France Thirty to seventy percent of coronavirus patients admitted to the intensive care unit (ICU) have suggested thrombus formation in the deep veins or lungs of the foot.

Around 1 in 4 Coronavirus patients admitted to the ICU develop pulmonary embolism.

These rates are much higher than typically seen in patients requiring admission to the ICU for reasons other than COVID-19.

High risk of stroke

Patients hospitalized with COVID-19 are also more likely to have a stroke than the general population.

In addition to increasing age, the likelihood of having a stroke is usually associated with other risk factors such as high blood pressure, elevated cholesterol levels, and smoking.

However, Higher stroke rate In patients with COVID-19, COVID-19 is somewhat unusual because it appears to occur in people under the age of 50 and lacks other risk factors for stroke.

Low levels of oxygen

COVID-19 also appears to be associated with small blood vessel thrombi, which are important for the movement of oxygen within organs. Autopsy report shows Within the cells that line these small blood vessels in the lungs, kidneys, and intestines, elements of SARS-CoV-2, the virus that causes COVID-19.

This creates small blood clots in these small blood vessels, impeding normal blood flow and the blood’s ability to deliver oxygen to these organs.

Importantly, these small blood clots can impair normal lung function. When these small clots reach the lungs, they can prevent oxygen from entering the blood as efficiently as it normally would. This may explain why oxygen levels in patients with severe COVID-19 are very low.

Treatment and diagnosis of blood clots is difficult

When patients are hospitalized, they are usually given low doses of anticoagulants to prevent the development of blood clots if they remain in bed because of a coronavirus or other medical condition.

However, patients with COVID-19 appear to be at increased risk of developing a blood clot, and the need for high doses of anticoagulant to prevent these coagulation complications is currently under debate.

Attempts are being made to answer this important question.

Diagnosing these clots in patients with COVID-19 can also be particularly difficult.

First, the symptoms of worsening pulmonary infections associated with the virus may be indistinguishable from the symptoms of pulmonary embolism.

Another challenge with COVID-19 is that the virus can affect laboratory tests and be used to diagnose venous thrombosis.

A good example of this is a test called D-dimer. This is a measure of coagulation in the body. This test is usually elevated in almost everyone who has a new venous thrombosis. However, people with severe COVID-19 infections Can also have D-dimer rises simply due to severe infections.

In some patients, this means that the test is no longer useful in diagnosing blood clots.

Why does COVID-19 cause blood clotting?

One theory is that the rate of thrombus increase with COVID-19 is simply a reflection of being particularly ill and immobile.

However, current data suggest that the risk of blood clots in COVID-19 patients is significantly higher than that normally seen in patients admitted to hospitals or ICUs.

Another potential explanation is that the virus directly affects the cells lining the blood vessels. When the body fights an infection, the immune system is activated and tries to kill the intruder. Studies have shown that the activated immune system can cause blood clots.

In severe COVID-19, the immune system seems to overdrive. This can lead to unchecked activation of cells that normally stop blood clotting.

Another possibility is that the virus causes blood clots and offers survival benefits.

Another member of the Coronavirus family, the SARS virus, Further “activate” Blood coagulation proteins allow viruses to enter cells more efficiently.

However, whether this holds true for COVID-19 has not yet been investigated.

Interestingly, preliminary studies have shown that the commonly used anticoagulant heparin May have antiviral effects It binds to SARS-CoV-2 and inhibits a key protein used by the virus to latch into cells.

What we do know is that the complications of blood coagulation are rapidly emerging as a significant threat from COVID-19. In this area, we still need to learn a lot about the virus, how it affects blood coagulation, and the best options for the prevention and treatment of these clots.

Karl Heinz Peter, Laboratory Director, Deputy Director of the Institute for Atherosclerosis and Vascular Biology and Baker Heart and Diabetes. Interventional Cardiologist, Alfred Hospital; Professor of Medicine and Immunology, Monash University Baker Heart and Diabetes Research Institute; Hannah Stevens, Hematologists, PhD students, Baker Heart and Diabetes Research Institute,and James McFadien, Baker Heart and Diabetes Institute, Hematologist, Researcher at Alfred Hospital, Baker Heart and Diabetes Research Institute

This article has been reissued from conversation Under Creative Commons license. Read Original work.