Blood Clotting Abnormalities Reveal COVID-19 Patients At Risk For Thrombotic Events

According to thrombosis expert Prof Beverley Hunt, sticky blood is having wider repercussions than just blood clots - it's also leading to higher rates of strokes and heart attacks.

According to a report published on the Journal of the American College of Surgeons website, the clots, also known as thrombosis,could be contributing to the number of people dying.Patients worldwide are being affected by many medical complications of the virus, some of which can be fatal.

Back in March, as coronavirus was spreading across the globe, doctors started seeing far higher rates of clots in patients admitted to hospital than they would normally expect.And there have been other surprises, including the discovery of hundreds of micro-clots in the lungs of some patients.When researchers from the University of Colorado Anschutz Medical Campus, Aurora, used a combination of two specific blood-clotting tests, they found critically ill patients infected with Coronavirus Disease 2019 (COVID-19) who were at high risk for developing renal failure, venous blood clots, and other complications associated with blood clots, such as stroke.

Their study, which was one of the first to build on growing evidence that COVID-19-infected patients are highly predisposed to developing blood clots, linked blood clotting measurements with actual patient outcomes.The research team is now participating in a randomized clinical trial of a drug that breaks down blood clots in COVID-19-infected patients.”This is an early step on the road to discovering treatments to prevent some of the complications that come with this disease,” said Franklin Wright, MD, FACS, lead author of the research article and an assistant professor of surgery at the University of Colorado School of Medicine.Patients who are critically ill regardless of cause can develop a condition known as disseminated intra vascular coagulation (DIC).

The blood of these patients initially forms many clots in small blood vessels. The body’s natural clotting factors can form too much clot or eventually not beable to effectively form any clot leading to issues of both excessive clotting and excessive bleeding. However, in patients with COVID-19 the clotting appears tobe particularly severe and — as evidenced by case studies in China and elsewhere– clots in COVID-19 patients do not appear to dissipate, explained Dr. Wright.

Thromboelastography (TEG) is a whole blood assay that provides a broad picture of how an individual patient’s blood forms clots,including how long clotting takes, how strong clots are, and how soon clots break down. TEG is highly specialized and used primarily by surgeons andanesthesiologists to evaluate the efficiency of blood clotting; it is not widely used in other clinical settings.
“The COVID pandemic is opening doors formultidisciplinary collaboration so trauma acute care surgeons and intensivistscan bring the tools they use in their day-to-day lives and apply them in the critical care setting to new problems,” Dr. Wright said.According to thrombosis expert Prof Beverley Hunt, sticky blood is having wider repercussions than just blood clots – it’s also leadingto higher rates of strokes and heart attacks.”And yes sticky blood is contributing to high mortalityrates,” she says.

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