People generally think of COVID-19 as a respiratory disease, one that affects the lungs. And it is.
“But this disease does not just attack the lungs,” says Stefan Kénel-Pierre, M.D., a vascular surgeon with the University of Miami Miller School of Medicine. “It attacks the whole body, and can cause serious problems with excessive blood clotting.”
Many studies confirm that COVID-19 patients are at increased risk for the formation of dangerous blood clots, which can cause heart attacks, strokes, and other crises. These studies include a recent report in the Journal of the American Medical Association.
Dangerous clots may form in arteries, which carry blood away from the heart, or veins, which return blood to the heart. “Clots in veins can break off and travel to the lungs. Additionally, arterial blockages can impair the delivery of oxygenated blood to the heart or brain,” says Dr. Kénel-Pierre. These situations can set the stage for emergencies such as heart attacks and stroke.
“Clots in arteries that bring blood to the legs and the arms can also occur,” he says. “These can lead to the loss of limbs.”
“To prevent these kinds of problems, COVID-19 patients are now often placed on some form of anticoagulant therapy,” says Dr. Kénel-Pierre. They may take low or high doses of anti-clotting drugs, depending on the severity of their illness and other risk factors.
JAMA study shows a higher percentage of clotting deaths
The JAMA study described the cases of 3,334 patients above the age of 18 hospitalized in New York during March and April of 2020.
Sixteen percent of the patients experienced one or more clotting problems while being treated for COVID-19. Two percent of them suffered a stroke; 9% had a heart attack; the rest had other problematic clots. Forty-three percent of COVID-19 patients who had clotting problems died, compared to 21% of COVID-19 patients without clotting problems.
Risk factors for having clotting problems along with COVID-19 included older age, being male, and being of Hispanic ethnicity. Patients who have diabetes, heart disease, or had had a prior heart attack also face higher risks. “These findings line right up with earlier studies which have all suggested a greater risk for abnormal clotting in COVID-19 patients,” says Dr. Kénel-Pierre.
Care for COVID-19 patients has been shifting due to growing awareness of abnormal clotting. Increasingly, doctors are using anti-clotting drugs to reduce the risks of deadly events.
Milly Dawson is a contributing writer for UMiami Health News.
A new paper by vascular surgeons at the University of Miami Miller School of Medicine, published in the Journal of Vascular Surgery, describes how thrombosis (blood clots in the circulatory system) was an early indication of infection in a COVID-19 patient. Read more.
Otherwise healthy adults are suffering from strokes due to the infection even when they have not had other physical symptoms. The best defense is to know the signs and head to the emergency room as soon as possible. Be FAST.
“People don’t really talk much about vascular health, and patients often have symptoms like pain that occurs with walking, which they ignore for way too long,” says Dr. Kénel-Pierre. Read more.