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After 18 days in an intensive care unit in Los Angeles, specialists treating the serious 19-year-old Canadian actor Nick Cordero were forced to amputate his right leg. The reason was a blood clot blocking the blood, France reported.
This is one of the dark discoveries of the pandemic: Covid-19 disease attacks other organs besides the lungs. The call. “Thrombotic events” can occur for various reasons among patients in the intensive care unit, but their proportion among patients in Covid-19 exceeds expectations. The relatively young age of patients with similar problems is surprising.
“We have had 40-year-old patients in the intensive care unit with blood clots in their fingers that seem to leak, and there is no reason other than the virus,” says Dr. Shari Broshannon of New York University Hospital. One of them suffers from blood circulation problems in all four extremities, a case in which amputation may be necessary.
Blood clots are not only dangerous for the extremities. They can reach the lungs, heart, or brain, where they cause lethal pulmonary embolism, heart attack, and stroke, respectively.
A recent study from the Netherlands, published in Thrombosis Research, found that 31 percent of 184 patients suffered from thrombotic complications, a number that experts call “remarkably high”, even if extreme amputation results are rare.
Why is this happening? Behnud Bickelli, a physician at New York Presbyterian Hospital, is assembling an international consortium of experts to study the problem. Their findings were published in the journal of the American College of Cardiology.
Experts have found that the risks are so great that patients with Covid-19 may need anticoagulants for preventive purposes before requesting imaging studies. The reasons are not fully understood, but Dr. Bickelli offers several possible explanations.
People with severe forms of Covid-19 often have concomitant conditions, such as cardiovascular or lung diseases, which in themselves are associated with higher coagulation rates.
Furthermore, staying in an intensive care unit is associated with the likelihood of clot formation due to prolonged immobility. For this reason, long distance passengers are advised to move and stretch periodically.
It is now clear that Covid-19 disease is associated with an unusual immune response known as a “cytokine storm”. Some studies indicate that it is also associated with higher coagulation rates.
Experts suggest that something related to the virus itself can cause clotting. Similar precedents have been observed in other viral diseases.
A study published last week in the journal Lanset found that the virus could affect the endothelial lining of organs and blood vessels, which could theoretically play a role in the clotting process.
According to Shari Broshanon, while anticoagulants like heparin are effective in some patients, in others they don’t work because blood clots are too small, such as in capillaries. Unlike large blood clots in the lungs or brain, surgery is not practical in such cases and amputation is often the only possible result, explains the specialist, cited by BTA.
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