“Remarkably high rate” of blood clotting among COVID-19 patients, doctors say

National

(WTVO)–Doctors are finding that some COVID-19 patients are greater at risk for developing blood clots, according to a CNN report.

“The number of clotting problems I’m seeing in the ICU, all related to COVID-19, is unprecedented,” Dr. Jeffrey Laurence, a hematologist at Weill Cornell Medicine in New York City, wrote in an email to CNN. “Blood clotting problems appear to be widespread in severe COVID.”

Blood clots can be life threatening if they travel to the heart or lungs.

Laurence and his colleagues looked at autopsies on two patients and found blood clots in the lungs and just beneath the surface of the skin, according to a study published last week. They also found blood clots beneath the skin’s surface on three living patients.

In the Netherlands, a study found “remarkably high” rates of clotting among COVID patients who suffered pneumonia in the ICU–specifically 31% of 184 of them. A study of 81 similarly ill patients in Wuhan, China, found a 25% incidence of clots.

Just last Saturday, April 18, Tony Award-nominated actor Nick Cordero has had his his right leg amputated after suffering complications from the coronavirus.

An international consortium of experts from more than 30 hospitals gathered to consider the issue. Their conclusion: It’s unclear exactly why, but coronavirus patients may be predisposed to having clots.

Dr. Behnood Bikdeli, who helped coordinate the international coalition, said there are three major reasons why COVID-19 patients might have an especially high risk of clotting.

One is that vast majority of patients who become severely ill with coronavirus have underlying medical problems, such as diabetes, heart disease and high blood pressure. These patients — whether they have coronavirus or not – have a higher tendency to clot than healthy patients.

The second explanation is the body’s own immune response. Patients can experience a“cytokine storm,” where an overload of cytokines, or proteins, attempt to attack the virus and trigger hyperinflammation.

The third reason is that there could be something about the novel coronavirus itself that’s causing clots.

“This is one of the most talked about questions in COVID right now,” said Dr. Michelle Gong, chief of the division of critical care medicine at Montefiore Medical Center in New York City.

At Montefiore, they’ve started to put all COVID-19 patients on low doses of blood thinners to prevent clots, Gong said.

While a low dose of blood thinners to prevent clots is generally considered low risk, that might not be enough to prevent clots in some patients.

The director of an ICU at Massachusetts General Hospital described how a nurse recently had to constantly administer a blood thinner called heparin to a COVID-19 patient while the patient was undergoing kidney dialysis, because clots kept clogging up the tubing in the machine.

“We had the nurse at the bedside pushing heparin to keep the machine from clotting off. That’s very rare,” Dr. Kathryn Hibbert said.

Giving larger doses could make a patient bleed excessively, which can be deadly.

While studies sort this out, doctors are being extra vigilant with their COVID-19 patients.

“This is one of the many challenges in taking care of critically ill patients and trying to decide if what you’re seeing at the bedside is rare and happening by chance, or if it’s part of a larger pattern that could change your practice,” Hibbert said.

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