Could a mass clotting event explain the excess death rate, the hypoxia, the delirium
Stories are now appearing of a few youngish people losing fingers, toes or even getting a leg amputated. And strokes have been seen in some as young as 30. Coronavirus, it seems, doesn’t just cause blood clotting, it causes the large and small sort, arterial ones, venous ones, and now microclots, and many of them all through the lungs and other tissues. This might explain the hypoxia, and also the other cases of organ failure. And while strokes in 33 year olds are still very rare (even in Coronavirus patients) the clotting could be the factor that matters most in the lungs, and in mortality.
This also might explain why ventilators are not working too well. Ventilators are useful for “wet lung pneumonia” because they help use pressure to push fluid out of the lungs. But if the problem is massive clotting, the ventilators that everyone worked so hard to get might be the wrong solution.
It also suggests people in Covid-zones should be on the lookout for stroke type symptoms, and drinking plenty of water and keep moving around.
Mysterious blood clots are COVID-19’s latest lethal surprise
By AFP, DailyMail.co.uk
After he had spent nearly three weeks in an intensive care unit being treated for COVID-19, Broadway and TV actor Nick Cordero’s doctors were forced to amputate his right leg.
The 41-year-old’s blood flow had been impeded by a clot.
A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called “remarkably high” — even if extreme consequences like amputation are rare.
Coronavirus’s new mystery: It’s causing strokes in healthy people
“These people are clotting, and we can’t shut it off.”
— Katherine Harmon Courage, Vox
Even anticoagulants like heparin are not enough to stop the clotting:
“I’m a hematologist, and this is unprecedented,” says Jeffrey Laurence of Weill Cornell Medical College, who has been in the field for three decades. “This is not like a disease we’ve seen before.”
Laurence also describes the multitude of people sick with Covid-19 whose blood clots are plugging up the dialysis machines in their wards. Beyond that, he says, even “as the nurses are drawing their blood, it’s clotting in the tubes, and they’re on full doses of Heparin” and other blood-thinning medications. “Everyone is seeing a similar kind of thing,” he says.
— Katherine Harmon Courage, Vox
Lawrence saw a photo of a young Coronavirus sufferer with a pattern of skin lesions that was “a picture of microvascular clotting. Lawrence wondered if that kind of clotting was going on in the lungs, and then saw that it was in an autopsy.
Blood markers of clotting are up at 100 times normal:
Dr. Tiffany Osborn, a professor of surgery and emergency medicine at Washington University in St. Louis.
“We are seeing lab values that are off the wall,” she says. For example, doctors are seeing levels of a protein fragment called a D-dimer that are more than 100 times normal levels, Osborn says. This suggests the presence of lots of blood clots that the body is trying to break down.
Reports are coming in from all over the world:
Hundreds of small clots throughout the lungs also found in Ireland:
“In addition to pneumonia affecting the small air sacs within the lungs, we are also finding hundreds of small blood clots throughout the lungs. This scenario is not seen with other types of lung infection, and explains why blood oxygen levels fall dramatically in severe COVID-19 infection. — Fogarty et al 2020. ScienceDaily
Also in France: a quarter of ICU Covid patients had a pulmonary embolism (clot in their lung) and nearly 70% had some venous thromboembolism. (Llitjos, 2020)
Young people are not on the look out for stroke symptoms:
For example, the youngest, a 33-year-old woman, developed slurred speech and felt weak and numb on her left side for 28 hours before seeking help. She (as well as one other stroke patient in the study) was “concerned about going to a hospital during the pandemic,” the authors noted — even though she had had a cough, headache, and chills for a week.
She is one of the lucky ones. She is the only one who has been able to start speaking again.
Coronavirus deaths from stroke or heart attacks could be uncounted Covid deaths
If Coronavirus can cause strokes in otherwise healthy 33 year olds, imagine what happens to 80 year olds at home?
The prevalence of blood clots also raises the question of whether some stroke or heart attack home deaths in recent months were actually linked to Covid-19. It’s yet another possible way Covid-19 fatalities might be being undercounted. Many people who have already died are not currently tested for Covid-19 (often in the interest of preserving tests for those who are still alive). But more widespread posthumous testing could help clarify the full impact of this disease.
— Katherine Harmon Courage, Vox
Previously some docs suggested the “light lung” stage of Coronavirus (where lungs are still flexible and compliant) was a sort of high altitude sickness which leads to clotting. But this newer theory turns it around and suggests that the clotting itself causes the hypoxia which perhaps leads to the appearance of the high altitude sickness.
Obviously it’s not known how long people might be at an increased risk of stroke or heart attack after getting a coronavirus infection.Though there were reports out of China in early February of people having heart attacks weeks later and a suspicion that the virus was increasing the risk.
Note that even influenza increases the risk of heart attacks and strokes, and being immobile in an ICU bed is a well known factor promoting blood clots. That’s why patients are given prophylactic doses of heparin right from the start. The difference here is that the clotting is so strong that even higher doses of heparin are not enough to stop it clotting.
This doesn’t change the fact that it’s likely 75% of people will be asymptomatic or have mild cases.
Things worth knowing about Coronavirus:
- Quarantines work: 12 days after lockdowns, quarantines and isolation, Coronavirus slows. This is text book microbiology.
- Coronavirus causes clotting: hold the ventilators, stop blood clots instead
- Coronavirus can affect brains, may increase stroke risk.
- Solve Vitamin D deficiency first to help beat Coronavirus.
- New York is “like mass casualty event”: coronavirus and other deaths are up three-fold
- Coronavirus may be man made. Why did the CCP destroy the evidence?
- Looks like we can extinguish Coronavirus: Australia and NZ tracking to zero.
- Large coronavirus random tests in Austria show only 1% infected
- Read Crush the Curve — save the economy.
REFERENCES
Fogarty, H. et al (2020) . COVID‐19 Coagulopathy in Caucasian patients. British Journal of Haematology, 2020; DOI: 10.1111/bjh.16749
Klok, F.A. (2020) Incidence of thrombotic complications in critically ill ICU patients with COVID-19, Thombosis Research.
Magro, C (2020) Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases,
Saba, L. et al (2020) Is COVID Evolution Due to Occurrence of Pulmonary Vascular Thrombosis? J Thorac Imaging. 2020 Apr 28. doi: 10.1097/RTI.0000000000000530. [Epub ahead of print]
Griffin DO (2020) Pulmonary Embolism and Increased Levels of d-Dimer in Patients with Coronavirus Disease, Emerg Infect Dis. 2020 Apr 29;26(8). doi: 10.3201/eid2608.201477. [Epub ahead of print]
Llitjos et al (2020) High Incidence of Venous Thromboembolic events in anticogulated severe Covid-19.
Tang et al, (2020) Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy, J Thromb Haemost. 2020 May;18(5):1094-1099. doi: 10.1111/jth.14817. Epub 2020 Apr 27.