The recent observations by doctors that COVID-19 patients exhibit a range of clotting-related disorders has shifted the perception of the virus from being a typical respiratory disease to one that incites dangerous clotting. These clotting disorders have manifested in several forms from harmless skin conditions to severe strokes and blood vessel blockages.
Unraveling the Misconception of Lung Damage
There were initial assumptions that the majority of lung damage in COVID-19 patients resulted from viral pneumonia. However, autopsies of these patients revealed the presence of clumps of platelets, also known as microthrombi, within blood vessels that were responsible for the swift and severe worsening of patients’ conditions.
The Formation of Thrombi
Blood clots or thrombi are generally observed to develop in arterial catheters and filters used in the treatment of failing kidneys in these patients. These clots obstruct the flow of blood in the lungs, leading to a severe deficiency in blood-oxygen levels and resulting in breathing difficulties.
Pulmonary Embolism in COVID-19 Patients
Research has demonstrated that up to 30% of severely afflicted COVID-19 patients experienced a condition known as pulmonary embolism. This life-threatening blockage in one of the lung arteries often occurs when fragments of blood clots from deep veins in the legs move to the lungs. Compared to critical patients without COVID-19, the prevalence of pulmonary embolism stood at just 1.3%.
Detecting Blood Clots
To monitor the formation of clots in patients, including those with COVID-19, a D-dimer blood test is being employed worldwide. Alongside this test, heparin, and other anticoagulant medications, are being administered to patients.
The Historical Link between Viruses and Blood Clotting
The association between viruses and blood clotting is not new. The 1918 Spanish flu pandemic, caused by a novel strain of influenza, demonstrated similar patterns of clot formation that led to fatalities. Viruses such as HIV, dengue, and Ebola are also known to induce blood cell clumping. This pro-clotting effect seems to be significantly more pronounced among coronavirus patients.
Consequences of Blood Clotting in COVID-19 Patients
Lung Damage and Potential Cardiac Arrest
If these arterial lung clots go untreated, they place a tremendous strain on the heart, potentially leading to cardiac arrest. Even small clots formed in the lung tissue capillaries can disrupt blood flow, undermining measures to aid oxygenation via ventilators.
Damage to Vital Organs
Blood clots can form in other parts of the body, posing a risk to crucial organs, including but not limited to the heart, kidneys, liver, and bowel.
Mistaken Recurrence of COVID-19
COVID-19 survivors who subsequently experience difficulty breathing may misinterpret this as a relapse of the virus infection when it may instead be a resurgence of the clotting problem.
Associated Risks and Complications
Pulmonary embolism may also trigger pulmonary hypertension, another severe complication that results in fatigue and shortness of breath. Both patients and doctors might underestimate the risks involved or the potential requirement for treatment.
