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Once thought of as a flu-like infection, COVID-19 has gradually shown us that this is nothing like influenza and related flu-like illnesses. It has revealed its innumerable other manifestations. In addition to its well-known respiratory manifestations, patients with symptoms of COVID-19 may display symptoms that involve other organ systems.
Presentations with neurological problems, muscle aches, low platelets, heart problems, etc. they are not uncommon. Ignoring the early symptoms of COVID-19 and subsequent late diagnosis / treatment has often led to respiratory complications resulting in hospitalizations in serious or critical conditions.
Patients with comorbidities such as uncontrolled diabetes, morbid obesity, kidney failure, and immunosuppressed conditions such as organ transplants, blood-related malignancies are at much higher risk compared to patients without these pre-existing health conditions.
We have been fortunate to have faced the pandemic after several other countries earlier in the year. The experience of medical professionals in these countries has shed light on some complications of viral infection that ultimately lead to death. One of the most worrying and life-threatening complications of COVID 19 is the formation of blood clots in multiple arterial systems.
These blood clots or what is called “thrombosis” occur in the arteries and prohibit / slow down blood flow. This can lead to strokes, heart attacks, and more. Therefore, one of the most important aspects of treating COVID-19 in a significant number of patients includes medications that prevent or treat these blood clots.
Mahesh, 30 (name changed upon request) presented to the emergency room at Columbia Asia Hospital, Whitefield, with severe abdominal pain, just days after being released from another nearby hospital with COVID-19.
Later, he was admitted to Columbia Asia Hospital for treatment of a “heart attack” in the right kidney due to thrombosis or blood clots in the right renal artery. This was a complication of his recent COVID-19 infection.
Dr. Naveen Chandra, Consultant, Interventional Cardiologist, Dr. Narendra Reddy, Consultant, Vascular Surgeon, and Intensive Care Team led by Dr. Ramkumar from Columbia Asia Hospital, Whitefield evaluated the patient for the unusual complication and began treatment accordingly. In addition, an angiogram was performed and the doctors confirmed the presence of blood clots or thrombosis in the right kidney.
This caused ischemia, or reduced blood supply to the kidney, leading to a heart attack. The thrombus was immediately removed. He was treated with anticoagulants (blood thinners) and COVID-19 related medications accordingly. The patient was successfully discharged one week after admission.
Developing the case Dr. Naveen Chandra, Consultant, Interventional Cardiologist, Columbia Asia Hospital Whitefield said “It has now been shown very conclusively that COVID-19 infection not only causes respiratory problems, but can also induce blood clots in the arteries leading to life-threatening complications and morbidity. We see an increase in the incidence of heart attacks, strokes, clots in the pulmonary vessels during COVID-19 infection. Early recognition and prompt treatment are crucial to improve disease outcomes ”.
Dr. Indira Kedlaya, Consultant, Internal Medicine / Geriatrics, Columbia Asia Whitefield Hospital additional “The initiation of anticoagulation (blood thinners) for a few weeks is as important as treating the infection itself in large numbers of COVID patients.
They are treated with injectable anticoagulants in the early course of the disease and continued after discharge, either with injectable anticoagulants or oral anticoagulants for a few weeks. But in Mahesh’s case, she developed clots despite taking these medications. Therefore, a high index of suspicion is required to successfully identify and treat such complications. “
Mahesh has now recovered and has been released from the hospital on oral anticoagulants. He has followed up in the outpatient department and continues his recovery process.
