FORT LAUDERDALE, Fla. – Health experts encounter a rare and dreaded covid-19 complication: plug-like blood clots in the limbs of coronavirus victims that threaten circulation.
And that means you could lose a covid-19 limb, even if you did not lose your life.
Following questions about 10 major hospital networks in Florida, the South Florida Sun Sentinel has found 26 previously unreported examples of these coronavirus-causing lymph nodes. These clots contributed to the deaths of at least six of the patients.
And in at least one instance, surgeons at the University of Miami report amputating the leg of a Miami-Dade man in his mid-50s who lost limb circulation after contracting the virus .
Health laws prevented the release of more information about the man who lost his leg, and data has been scarce on amputations in Florida since the pandemic began. A spokeswoman for Florida’s Agency for Health Care Administration, which oversees amputated limbs, says they do not expect to have clear statistics on amputations by April next year because of the way hospitals report data on the procedure.
And doctors say they still do not understand how or when or why the virus causes these clots.
“We still do not know what … it does,” said Dr Mohammad Abdallah, a vascular surgeon with Broward Health, about the virus.
But the story of how David Guerrero, an otherwise healthy 48-year-old Fort Lauderdale airport worker, nearly lost his right leg to the virus serves as a cool reminder of the potential cost to our learning curve with this new disease.
Guerrero was not even sure if he had covid-19 when he started to lose his feeling in the right foot.
In the third week of July, he began to “feel pins and needles” at his extreme.
Three weeks earlier, Guerrero – who does not smoke and has no preconditions – had come down with what he thought was a bad stomach break. But the gastrointestinal symptoms remained a suspect for a long time. His doctor recommended a covid-19 test, but the results had not yet returned when Guerrero’s foot began to rumble.
Soon Guerrero could not run. It was the weekend, so he tried to stop calling the doctors, but the pain became unbearable.
‘I tried to sleep. I took a hot shower. I felt terrible. Man, I felt terrible, ”he said.
So Guerrero checked himself in the emergency room at Broward Health, and that’s when medical professionals told him he was in danger of losing his leg.
“There was no blood in his foot,” said Abdallah, who underwent Guerrero’s vascular surgery. He and his medical partner, both vascular surgeons with Broward Health, have seen at least six patients with limb-bearing lumps related to covid-19 since the start of the pandemic.
Abdallah suspected that covid-19 was the culprit behind Guerrero’s fever, and while he was in the ambulance, Guerrero’s coronavirus test returned positive, almost two weeks after he took it. An x-ray also showed evidence of infection in Guerrero’s lungs.
“His chest x-ray was classic for covid,” Abdallah said.
Abdallah decided to put Guerrero on powerful intravenous blood thinners to try to brush the clots. But after three days of blood donors doing nothing to the clots, Abdallah Guerrero told them to go in and breastfeed the clogs by hand.
‘At this point, he did not have much to lose. His limb would go if we left it alone, and if we intervened there was a possibility that he would keep it. ‘Sei Abdallah.
What the vascular surgery found in the arteries of Guerrero’s leg surprised him.
“It was almost like a plug,” Abdallah said of the hard, black clogs he removed by hand. “It was pretty extensive.”
Dr. Jorge Rey, head of vascular surgery at the University of Miami School of Medicine, said the vascular surgeons at his hospital network treated 20 patients with symptoms similar to Guerrero’s.
Rey said doctors can often save the arms and legs of younger people, but he said the appearance of the lumps – called “acute limb ischemia” – in older, sick people often heralds the onset of death.
“If acute ischemia is the first symptom we’ve seen in a few, then those patients are doing well,” Rey said. ‘If it happens after that, as a complication, then they are definitely dead. We can count at least six patients who died. ‘
Both Rey and Abdallah say that clinicians still do not fully understand how the virus causes these blood clots and that they occur not only in the limbs but rather all over the body, sometimes resulting in heart attacks and, in other cases, leading to strokes. .
It is unclear if coagulation of condition is related to other other existing conditions, such as diabetes or heart disease. At least two of the 26 individuals were otherwise healthy people, and data on pre-existing conditions for the other 24 were not immediately available.
“What is the molecular mechanism? Nobody knows yet, “Rey said.
Rey notes that he found no evidence of virus in the blood of humans when they get the fever, which means the clots are likely to be triggered by the human immune system.
One thing is clear, however: Clinicians still have much to learn about how SARS-COV-2, the virus that causes covid-19, interacts with the human body, and in some cases triggers incredibly powerful and potentially life-threatening and limb threats. responses of the immune system.
Guerrero said he was just happy that the virus did not cost him his leg below the knee.
“Man, I’m eternally grateful to Dr. Abdallah.”
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