We initially thought death from COVID-19 was mostly related to pneumonia in the lungs. Doctors are now learning of a startling discovery.
The actual cause of death may be the effect COVID-19 has on blood clotting
COVID-19 first appeared in China in December of 2019. Quickly, it spread like a massive tsunami around the world, leaving in its wake death, destruction, and confusion. It became an “all hands on deck” scenario as doctors, scientists, and drug companies scrambled to understand and contain the disease.
Now, as the fog begins to lift, we are able to see more clearly the causes and effects of COVID-19. For example, those patients who have the most severe manifestations of COVID-19 appear to have an alteration in the way their blood clots. This causes their blood to form small and large blood clots throughout their body, affecting various organ systems. A study out of MIT (Massachusetts Institute of Technology) found that 70 percent of those who died from COVID-19 had blood clots blocking small vessels.
When 41-year-old Broadway actor Nick Cordero contracted COVID-19, his wife, Amanda Kloots, posted on social media how the virus had caused blood clots to form in Nick’s right leg, requiring the leg to be amputated. Since then, Nick has not awoken, and as of this publication, he remains on a ventilator in critical condition.
What is a blood clot, and can it kill you?
The blood in your circulation stays in a constant balance between bleeding and clotting. If you get a cut, your body will trigger the blood in the area of the cut to “tip the scales” toward clotting, so you don’t bleed to death. While you want your blood to clot in those circumstances, some conditions can cause the scales can tip too far. In those conditions, clots can develop inside larger, more important blood vessels called arteries and veins.
A clot that forms in a major artery will prevent the oxygen-carrying, fresh blood from getting to that organ, thus “suffocating” that part of the body. A clot that develops in a major vein will prevent the used-up, oxygen-depleted blood from getting back to the heart and lungs to be refreshed, thus causing swelling and congestion. The worst-case scenario of a clot in a major vein, DVT (Deep Vein Thrombosis), is when the DVT breaks loose from the vein wall and travels to the lungs. This is called Pulmonary Embolism (PE), and it can cause chest pain, shortness of breath, heart strain, and sudden death.
What is the link between COVID-19 and blood clots?
It is widely known many victims of COVID-19 suffer from severe pulmonary complications requiring ventilator support. Initially, this was associated with “pneumonia-like” lung failure. However, according to a study led by Dr. Herman Poor out of Mount Sinai in New York, it appears the lung mechanics are well preserved. Still, the arteries to the lungs become blocked with clots preventing the blood from getting new oxygen in--and old carbon dioxide out. In the end, this results in multiple organ systems failing all at the same time.
The SARS COVI-2 virus responsible for the COVID-19 disease has some similarities to the SARS COVI-1 virus we saw in 2003 in that both cause massive inflammation and the formation of clots in large and small blood vessels throughout the body.
How has this information changed the way we treat COVID-19?
This new information has changed the way we handle blood clot prevention in those patients hospitalized with COVID-19. Typically, blood clot prevention would be given to those critically ill patients in the ICU by way of “low dose” blood thinning shots in the stomach. Now doctors are considering giving blood thinners in low doses to anyone hospitalized with COVID-19 and giving higher, more therapeutic doses to those in the ICU.
Understanding how to prevent blood clots is important to stay healthy in everyday life but is critical when you become ill, especially with COVID-19. Stay hydrated, stay active, and learn exercises to help prevent your legs from developing blood clots. If you are concerned that you may have a blood clot, Center for Vein Restoration offers DVT examination and treatment to patients in an outpatient setting.
Author: Zoe Deol, MD, FACS, DABVLM
Regional Medical Director at Center for Vein Restoration and Center for Vascular Medicine
Dr. Deol is double board certified in general surgery and venous & lymphatic medicine. She is scientifically published, and she is also a national and international speaker/educator on venous and lymphatic disease. She currently practices in metro Detroit and the greater Toledo area.