A new cause of COVID-19 thrombus has been identified

Blood clots continue to cause havoc in patients with severe COVID-19 infections, and a new study explains that up to half of patients can have blood clots.

Criminal: Circulating autoimmune antibody blood, Attacks cells and induces blood clots in arteries, veins, and microvessels. Blood clots can cause life-threatening events such as stroke. Also, in COVID-19, microscopic blood clots can limit pulmonary blood flow and impair oxygen exchange.

Other than new coronavirus infections, it causes these blood clots antibody Normal, patient People with antiphospholipid antibody syndrome, an autoimmune disease. The relationship between autoantibodies and COVID-19 was unexpected, said co-author Yogen Kanthi, MD, an assistant professor at the Frankel Cardiovascular Center in Michigan Medicine and a Lasker researcher at the National Institute of Cardiopulmonary Blood at the National Institutes of Health. I will.

“Patients with COVID-19 have a relentless cycle of self-amplification of inflammation and coagulation in the body,” says Kanti. “Now we are learning that autoantibodies can be responsible for this loop of coagulation and inflammation that makes people who are already suffering even more ill.”

“Some of the worst coagulations we have ever seen”

Co-author Jason Knight, MD, a rheumatologist in Michigan medicine, has been studying antiphospholipid antibody syndrome antibodies in the general population for many years.

“Half of the patients hospitalized for COVID-19 were positive for at least one of the autoantibodies, which was very surprising,” said an associate professor of internal medicine and a leading autoantibody-induced disease. Knight, who is also a person, says.

New Scientific translation medicine Publications show that about half of patients who are very afflicted with COVID-19 show high levels of both dangerous antibodies, which are destructive and explosive white blood cells, and hyperactivated neutrophils. understood. In April, the team first reported high levels of neutrophil extracellular traps in the blood of patients admitted with severe COVID-19.

To find out more, they studied explosive neutrophils and COVID-19 antibodies together in a mouse model to see if this could be a dangerous combination behind a blood clot.

“Antibodies from patients with active COVID-19 infections have caused significant amounts of coagulation in animals, which is some of the worst coagulations we have ever seen,” Kanthi said. I will. “We have discovered a new mechanism by which patients with COVID-19 can develop blood clots.”

Attack the blood clot of COVID-19 from all angles

Researchers say these findings aren’t ready yet Clinical practiceHowever, they add a new perspective to the study of strong thrombosis and inflammation in COVID-19 patients.

Kanthi, Knight, lead author Yu (Ray) Zuo, MD, and colleagues want to know if severely ill patients with high levels of these antibodies will have better results if the antibodies are blocked or removed. thinking about.

If so, it may justify aggressive treatments such as plasmapheresis, which is commonly used in severe autoimmune diseases, Zuo explains. This involves draining blood through IV, filtering it, and replacing it with fresh plasma that does not contain antibodies associated with blood clots.

“We know that people with the highest levels of autoantibodies worsen in respiratory function, and antibodies also cause inflammation in healthy cells,” said Zuo, an assistant professor of internal medicine and a rheumatologist in Michigan medicine. Says.

“We still don’t know what is triggering the body to produce these antibodies, so the next step will be additional research to identify antibody triggers and targets,” Knight said. Adds.

In addition, these findings raise new questions surrounding the use of convalescent plasma as a potential treatment for COVID-19, but the team said further research is needed to investigate this concern. I have.

“We are currently investigating how long these antibodies will continue to circulate after recovering from the new coronavirus,” says Knight.

Researchers are currently conducting a randomized clinical trial called DICER.It tests patients with COVID-19 with the well-known anticoagulant dipyridamole to determine if excessive reduction is more effective than placebo. Blood clot..

“Dipyridamole is an old drug that is safe, cheap, and expandable,” says Kanti. “The FDA approved it 20 years ago to prevent coagulation, but recently discovered the potential to block this particular type of inflammation that occurs with COVID.”