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Blood Clotting In Covid Patients: Experts Share Insights

Ambarish Satwik, a vascular surgeon at Sir Ganga Ram Hospital, on Wednesday posted on Twitter a photo of a blood clot that formed in a Covid patient. Read here to know more about this complication of covid-19 infection.

Blood Clotting In Covid Patients: Experts Share Insights

Cytokine response of the body is the exact mechanism behind clotting, says Dr. Naresh Trehan

India, battling the second wave of the coronavirus, is reporting over three lakh cases every day. The second wave is different from the first one in many ways. This time, virus strains are said to be driving the infections. There have been more cases of breathing difficulty, chest pain, palpitation and heart attacks or heart failure.

Ambarish Satwik, a vascular surgeon at Sir Ganga Ram Hospital, on Wednesday posted on Twitter a photo of a blood clot that formed in a Covid patient.

"What Covid clots look like. Covid produces blood clots. The incidence of heart attack, stroke, or limb loss due to an arterial clot in Covid varies from 2%-5%. We pried these out of the lower limb arteries of a Covid patient. We were able to save the limb," reads his tweet.

Speaking to DoctorNDTV, Dr. Satwik said, "Covid may lead to thrombosis, which means formation of clots in the blood vessels. Covid produces endothelial dysfunction which leads to formation of thrombus in the blood vessels that may completely cut down circulation to or from an organ."

On the same, Dr. Naresh Trehan explains, "In Covid patients, the cytokine response of the body is the exact mechanism behind clotting. Cytokine is a defence system of the body to fight against any foreign protein."

He further explains the different phases of this clot formation and adds, "The first 5-7 days period is called the replication phase of the virus during which it multiplies in the body. When the virus load reaches to a certain level, the body responses against it (as the body does not have any antibodies against this particular virus), this body's response is from the immune system. So, when the immune system gets activated, cytokine is released. Some people have a very strong cytokine response which we call cytokine storm."

"As cytokines are inflammatory in nature, they may also inflame the normal cells during this response. Doctors from Bergamo, Italy found that the cytokine inflames the walls of the arteries along with the rest of the organs. As a result, in the smaller arteries where the flow of the blood is slower than normal, there can be formation of clot in the capillaries. The tissues get inflamed as well as the arteries get blocked, so it a dual mechanism."

"The incidence of clots in the blood vessels is very high. If the clot is formed in the coronary artery, which supplies to the heart, it may result in a heart attack. Similarly, if the clot is present in the blood vessels that supply the brain, a patient might get a stroke. In some cases, peripheral blood vessels involvement may lead to limb loss. The incidence of this arterial thrombosis is 2-5 %. Whereas, as per observational studies, the incidence of venous thrombosis is pretty high that is around 14-25%," Dr. Satwik adds

The link between covid and heart disease risk

Dr. Satwik explains, "Covid may lead to viral myocarditis or clot in the arteries, both these can be the reason behind acute myocardial infraction which is a known phenomenon in covid. Sometimes, even young people can get a heart attack, stroke or peripheral thrombotic occlusions."

What should patients do?

Symptoms like persistent palpitations, chest pain, tightness in the chest, light headedness or pain in the jaw region could be the signs of the heart attack. During covid, patients should report any new symptoms to the doctor immediately. If there is sudden pain or numbness in the body or the abdomen, the doctor may advise imaging test, adds the doctor.

How to reduce the risk of clot formation or heart attack in covid patients?

"Inflammatory markers including D-dimer and CRP should be investigated by the doctor. If these are found to be elevated, you need treatment blood thinners prescribed by the doctor."

"A covid patient should be in constant touch with a physician to address any new symptoms timely," he concludes.

The harmful effect of the clots

Dr. Trehan adds,"One can get clots in the brain, lungs, kidneys, liver or any other part of the body. First wave we knew this happens, but not many cases were reported. Now, the cases are high."

Further, Dr. Trehan comments on the possibility of the third wave, "We did not expect the second wave to be so strong. If we compare it with the Spanish flu which had a less intense third waves, there may be a third wave because historical facts cannot be ignored. But nobody knows the exact way this virus will behave in third wave."

"We have seen many young people die due to heart attack. So, everybody must be cautious and monitored properly by a trained physician or a specialist. Also, people suffering from post-covid syndrome should stay in constant touch with their doctors," he adds.

(Dr Naresh Trehan, Chairman and Managing Director of Medanta Hospital)

(Ambarish Satwik is a vascular surgeon at Sir Ganga Ram Hospital)

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Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.


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