Why COVID-19 Causes Lung Embolism, Blood clotting, Bleeding and Who Is More At-Risk

    A recent study headed by academics at Ume University in Sweden verified previous findings showing the majority of Post-COVID persons are at an increased risk of deep vein thrombosis, pulmonary embolism, and hemorrhage!

    The study findings revealed that, regardless of initial asymptomatic or symptomatic manifestations at infection, there was an increased risk of deep vein thrombosis (a blood clot in the leg) up to three months, pulmonary embolism (a blood clot in the lung) up to six months, and a bleeding event up to two months after COVID-19 infection.

    Due to the observational nature of this study, the researchers cannot conclusively determine cause, and they note various limitations that may have influenced their findings.

    For example, VTE may have gone undiagnosed in COVID-19 patients, COVID-19 testing was limited, especially during the first pandemic wave, and vaccination information was scarce.

    But the question is what causes them. Another study may have the answer.

    Another study found that the blood of some COVID-19 patients is thicker than normal. According to the authors of a short investigation, this may explain the prevalence of blood clotting among patients with new coronavirus disease.

    Researchers from Emory University in Atlanta discovered a relationship between hyperviscosity and COVID-19. This can occur for a variety of causes, including an increase in blood plasma components such as red and white blood cells, platelets, or proteins, or because red blood cells are malformed.

    Blood clots are becoming increasingly common among COVID-19 patients, according to the authors of the study published in the journal The Lancet. After noticing this tendency in their patients, the team set out to find an explanation.

    In an Emory University intensive care unit, 15 critically ill COVID-19 patients took part in the study. The patients were all given blood clot-prevention medicines, yet the viscosity of their blood plasma was 95 percent higher than normal, according to the researchers. A pulmonary embolism, a limited blood supply in a leg, and clotting connected to a kidney support system were among the four patients who developed blood clots. The researchers also discovered a substantial link between plasma viscosity and the Sequential Organ Failure Assessment score, which is used to determine how dangerously ill a patient is.

    According to the researchers, the patients’ levels of fibrinogen, a protein found in blood plasma, were significantly higher. According to them, this confirms prior reports of elevated levels of the drug in COVID-19 patients.

    According to the authors, more research is needed to determine which blood components may cause hyperviscosity in COVID-19 individuals.

    One such study, published in the journal The Lancet Respiratory Medicine, found blood clots in the lungs of African American patients in New Orleans. The findings were based on autopsy performed with the consent of the patients’ next of kin on ten patients who died of COVID-19.

    Senior author Dr. Richard Vander Heide said: “We found that the small vessels and capillaries in the lungs were obstructed by blood clots and associated hemorrhage that significantly contributed to decompensation and death in these patients.

    “We also found elevated levels of D-dimers—fragments of proteins involved in breaking down blood clots. What we did not see was myocarditis, or inflammation of the heart muscle, that early reports suggested significantly contributes to death from COVID-19.”

    Professor Robert Storey of the University of Sheffield, who was not the part of the study said: “It is now well-recognized that inflammation in the body leads to increased risk of clot formation because the concentrations of proteins in the blood plasma responsible for clot formation increase in line with the extent of inflammation.

    “What has surprised many clinicians is the dramatic nature of the inflammatory response in COVID-19 that leads to the life-threatening complications and it seems we are seeing an exaggerated clotting response in some hospitalized patients.”

    This means that low doses of anticlotting medication are likely to be insufficient to cope with the problem, according to Storey, “partly because the dose is low and partly because the effects wear off before the next injection is given.

    “However doctors have to balance the risk of clotting with the risk of bleeding, particularly in COVID-19 patients who develop failure of multiple organs including the liver (which produces clotting proteins) or need invasive procedures performed.”

    People with illnesses of the arteries that supply the heart muscle or the brain are more susceptible to blood clotting conditions such deep vein thrombosis, according to Storey.

    “We need to develop personalized strategies for controlling clotting risk in patients with COVID-19 or other conditions associated with excessive inflammation.”

    Image Credit: Getty

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