Whereas respiratory points proceed to be the commonest symptom of a COVID-19 an infection, new analysis signifies the illness is also related to hypercoagulability, or elevated tendency of the blood to clot. In a brand new examine printed November 20, 2020 within the journal EClinical Medication by The Lancet, researchers from UC San Diego Well being discovered that blood clots led to an elevated danger of demise by 74 %.
Led by Mahmoud Malas, MD, division chief of Vascular and Endovascular Surgical procedure at UC San Diego Well being, researchers reviewed 42 totally different research involving greater than 8,000 sufferers identified with COVID-19. Utilizing random fashions, the staff produced abstract charges and odds ratios of mortality in COVID-19 sufferers with thromboembolism, blood clots — and in contrast them to sufferers with out these situations to find out what impact blood clots could have on danger of demise.
“We started to note a extremely uncommon manifestation of venous and arterial thromboembolism in sufferers with COVID-19,” stated Malas. “Along with increased situations of blood clots, the mortality for sufferers hospitalized for COVID-19 and with thromboembolism was a lot increased, in comparison with sufferers with out clots. It is uncommon as a result of we’ve by no means seen something like this with different respiratory infections.”
General, 20 % of the COVID-19 sufferers have been discovered to have blood clots within the veins, and amongst sufferers within the intensive care unit, that statistic elevated to 31 %.
Blood clots within the vein, or deep vein thrombosis, can attain the lungs and become pulmonary embolism, leading to increased danger of demise. Blood clots within the arteries could result in limb amputation if not handled surgically in a well timed trend.
Within the examine, Malas and colleagues carried out a systemic evaluation by way of meta-analysis, which is a statistical methodology that allowed researchers to mix a number of research to provide a single complete paper.
“The collective expertise within the literature as captured on this meta-analysis examine brings extra gentle on the significance of blood vessel clotting occasions in hospitalized sufferers with COVID-19,” stated Bryan Clary, MD, surgeon-in-chief at UC San Diego Well being and co-author of the examine. “Whereas the frequency of those occasions is way increased than anticipated, our examine possible underestimates the incidence of thromboembolism within the international inhabitants of sufferers with COVID-19, together with non-hospitalized sufferers.”
In accordance with Malas, arterial blood clots creating in folks with the flu is extraordinarily uncommon, and the speed of clotting in sufferers with COVID-19 is increased than what’s reported for different viral pandemics, together with the H1N1 influenza of 2009.
Related signs are shared between influenza and SARS-CoV-2, reminiscent of fever, cough, shortness of breath, or fatigue. Blood clotting can happen in sufferers hospitalized with the flu, however solely in veins. For sufferers with COVID-19, blood clots can seem in both veins or arteries.
Usually, clotting within the arteries is brought on by well being components, reminiscent of atrial fibrillation, hypertension, excessive ldl cholesterol, diabetes, or way of life selections like smoking. Sufferers who’re hospitalized for lengthy intervals of time are additionally extra in danger for blood clots within the vein resulting from immobility.
Blood clots within the vein are handled or prevented with prescribed blood thinners. Proactively administering such medicines to hospitalized sufferers may also assist stop clots from forming. Medical trials are ongoing to find out how blood thinners can cut back the chance of clotting in sufferers with COVID-19.
“What we will study from this paper is due diligence,” stated Malas. “We’re nonetheless within the strategy of understanding the pathophysiology of COVID-19, so it is necessary to have a low index of suspicion on the subject of this an infection to make sure we’re doing all we will to mitigate the unfold and stop extreme outcomes.”
Co-authors embrace: Isaac N. Naazie, MD, MPH, Nadin Elsayed, MD, Asma Mahlouthi, MD, and Rebecca Marmor, MD, all at UC San Diego.