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A study has been published in the British Journal of Haematology which shows that many patients infected with the coronavirus develop microclots of the blood. Scientists point out that thrombosis is often the major cause of death.
Previous studies show that blood coagulation disorders, especially in the pulmonary vessels, may accompany SARS-CoV-2 coronavirus infection and contribute to the severe course of COVID-19. Moreover, one Chinese study found that elevated blood levels of D-dimer were associated with poor prognosis in COVID-19 patients. D-dimers are a breakdown product of blood clots, and their elevated levels indicate the occurrence of venous thrombosis.
See also: Another factor that causes people to die from COVID-19 has been discovered
Autopsy results of patients who died from COVID-19 show the presence of disseminated microclots (disseminated intravascular coagulation) in small vessels of the lungs and the accompanying tissue necrosis. More and more data also show that in severe cases of COVID-19, the risk of venous thrombosis and pulmonary embolism increases, which significantly increase the risk of death. Patients with COVID-19 also experience heart attacks and strokes associated with blood clots.
Also read: Coronavirus can cause strokes in middle-aged people
Until now, however, research on this topic has been conducted mainly in China, which is important because the Chinese generally have a three to four times lower risk of venous thrombosis compared to white people. Black people, on the other hand, have a higher risk of thrombosis compared to whites.
Researchers from the Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences conducted a study among 83 COVID-19 patients admitted to St James’s Hospital in Dublin between March 13 and April 10. Patients ranged in age from 26 to 92 years old. The majority were white people.
In 67 percent shortly after admission to the hospital, significantly increased levels of D-dimer were found. However, thrombotic changes in the vessels were not detected. Further observations confirmed that patients with high levels of D-dimer, after arriving to the hospital, more often needed a stay in the intensive care unit. In patients with poor prognosis, high levels of D-dimer persisted over the following days. Some other parameters indicative of a bleeding disorder were also altered.
According to the authors of the study, these results indicate that coagulation disorders in patients with COVID-19 are associated with pathological changes in the lungs associated with this disease.
– Our new observations indicate that COVID-19 is associated with an atypical type of blood coagulation disorders, which primarily affect the lungs and which undoubtedly contribute to high mortality in patients with COVID-19 – commented the co-author of the work, Prof. James O’Donnell, director of the Irish Vascular Biology Center.
As he explained, in addition to pneumonia, which affects the small alveoli, in patients with this infection, hundreds of small clots in the tiny vessels of the lungs are also seen. This sets COVID-19 apart from other infections that involve the lungs, and could explain why blood oxygen levels drop dramatically in patients with severe forms of the disease.
– Understanding how these micro-clots in the lungs are formed is crucial for developing more effective treatments for our patients, especially in high-risk groups – emphasized Prof. O’Donnell. He added that more research is needed to assess whether various anticoagulant therapies can lower the risk of blood clots in patients with COVID-19 at particular risk of its severe course. In the study group, patients receiving low molecular weight heparin (an anticoagulant drug) did not experience disseminated intravascular coagulation.
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The authors speculate that the race-specific predisposition to blood clotting disorders could largely account for differences in COVID-19 mortality in different parts of the world.
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