Covid-19 not just lung disease, can also cause lethal blood clots: Experts

There is increasing evidence to suggest that Covid19 is not just a disease of the lungs as initially thought but can also cause dangerous blood clots which need to be immediately removed to save limbs in some cases say expertsGlobal studies have shown that the prevalence of blood clot formation known as deep vein thrombosis DVT in hospitalised Covid19 patients is 1428 per cent and is a lower 25 per cent for arterial thrombosisThe India experience is similar said experts stressing that the infection is about the blood vessels as much as about the lungsWe are dealing with fivesix such cases per week on average This week it has been one a day of such complications said Dr Ambarish Satwik vascular and endovascular surgeon at Delhis Sir Ganga Ram HospitalThe prevalence of blood clot formation in Covid19 is high in patients who have conditions such as type2 Diabetes Mellitus although the exact incidence remains unknown added Dr Amrish Kumar consultant cardiothoracic vascular department Aakash Healthcare in southwest Delhis Dwarka localityWhile DVT is a serious condition that occurs when a blood clot forms in a vein located deep inside the body arterial thrombosis is a clot that develops in an artery Arteries are blood vessels that carry oxygenrich blood away from the heart to the body while veins carry blood low in oxygen from the body back to the heartSatwik drew attention to the Covid19 clot connection in a tweet earlier this week in which he posted a picture of a blood clot cast taken out from the lower limb arteries of a Covid19 patientWhat Covid19 clots look like Covid19 produces blood clots The incidence of heart attack stroke or limb loss due to an arterial clot in Covid19 varies from 2 per cent5 per cent We pried these out of the lower limb arteries of a Covid19 patient We were able to save the limb Satwik said on May 5Explaining his tweet which attracted a lot of attention and questions too Satwik said the Covid19 patient had an acute circulatory cut off because of the clots and the limb was threatenedSo we had to physically do a surgical procedure and extract these clots otherwise there would have been gangrene and he would have ended up with an amputation We were successfully able to take the clots out and save the limb the surgeon explainedAuthors of a Lancet paper published in November last year said studies suggested there is increased association between Covid19 and the risk of thromboembolism TE or obstruction of a blood vessel by a blood clotThe authors of the paper concluded that TE rates of Covid19 are high and associated with a higher risk of deathWe have been understanding the pathophysiology of Covid19 for over a year now When it first hit China and the global west it was thought that it was typical viral pneumonia Severe cases of acute Covid19 were being labelled as similar to the acute respiratory distress syndrome ARDS which leads to respiratory failure Satwik notedHowever a series of autopsies on Covid19 patients and their lungs revealed that what the doctors were seeing was not typical ARDSin addition to that they were finding clots in the microcirculation of the lungs So it was then kind of understood that Covid19 is as much a disease of blood vessels as much its a disease of the lungs Satwik addedIn a Covid19 patient when blood vessels are injured they produce a protein that attracts platelets and other clotting factors that come together to form a clot Kumar addedStudies have shown that around 20 to 30 per cent of hospitalised Covid19 patients have developed this complication he told PTIBecause blood vessels are everywhere on the body these clots could form anywhere Satwik said Some of these clots occupy big blood vessels and become macroscopic blood clotsBut otherwise we are seeing diffused microscopic clots in microcirculation in various organs he notedAccording to a University of Oxford study published in April the risk of rare blood clotting following Covid19 is around 100 times greater than normalThe research found that the rare blood clotting known as cerebral venous thrombosis CVT a blood clot of a cerebral vein in the brain is more common after Covid19 than in any of the comparison groups with 30 per cent of these cases occurring in the under 30sThe study covered 500000 Covid19 patients The risk would be 39 in a million according to its findingThe signals that Covid19 is linked to CVT as well as portal vein thrombosis a clotting disorder of the liver is clear and one we should take note of said Oxfords Maxime Taquet one of the authors of the studyExplaining how the virus causes blood clots in Covid19 patients Satwik said the virus is known to attach itself to the inner lining of the lung and right next to these air sacs are very thin blood vessels or capillariesThe virus invades these blood vessels and starts affecting the inner lining of these blood vessels which produces a dysfunction within the blood vessels which produces these clots the surgeon saidAs a result he said some clinicians were using blood thinners as part of the treatment and getting successWhat we have understood is these micro clots need immediate retrieval in order to save the limbs Satwik addedHe also said it is very difficult to know the prevalence of clots in the entire population infected with Covid19Although it is difficult to determine the vulnerability of Covid19 individuals with existing cardiovascular morbidities are the ones who will suffer thrombotic complications Satwik saidAccording to Kumar in Covid19 patients the clots seem to form in the tiny vessels of the lungs rather than the major vessels adding that clots in the lungs usually happen in the case of typical strokes or heart attacks or deep vein thrombosisRisk of Covid19 patients associated with blood clots are stroke clot in the cerebral artery clots in the lungs heart attack deep vein thrombosis and thrombosis in both upper and lower limb arteries Stroke can cause paralysis but we have not seen any such so far in our hospital Kumar addedIndia on Friday saw a singleday rise of 414188 Covid19 infections and 3915 fatalities pushing the countrys tally of cases to 21491598 214 million214 crore and the death count to 234083This story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliability and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever