A: While it is scary, it isn’t surprising. We still don’t know why this is happening. But here are a few key hopeful points.
1-This isn’t rare. Clots have long been a concern for critically ill patients in the ICU. We have also seen similar patterns in previous viral outbreaks (H1N1, SARS). Given the rise in cases of clot related events in COVID-19, researchers have a greater chance to examine the data and better understand why this is happening (so perhaps they can come up with better treatments and/or preventative strategies).
2-People with more severe illness (COVID-19) are more likely to develop clotting issues. They can have both micro (small) and macro (large) vasculature clots. These clots can lead to stroke or other severe complications. These individuals can have abnormal lab values indicating widespread clotting issues and/or disseminated intravascular coagulation (where clotting factors are used up, leading to excessive bleeding). Sounds bad, but keep in mind these are people who are already critically ill. On the other hand, people with less severe symptoms are much less likely to have this complication.
3-Traditional anticoagulation may not break up these clots; higher doses and specified regimens may be needed for hospitalized patients; however caution is needed to minimize side effects from agents used in the hospital to “thin” the blood such as heparin. The good news is that we know how to treat clots in general and this may help us to treat COVID-19 related clots! (Recent scientific articles: here and here.)
4-Preventative medication (to “thin” blood) such as Aspirin is not recommended unless already part of your regimen (recommended by a prescriber). But we don’t know everything yet. It is interesting to note that a trial is underway to examine if there is a benefit to taking a daily Aspirin to prevent complications in COVID-19.
The bottom line, yes this may seem scary. But, we have seen this before. What that means is that our hospital teams can recognize this, treat this, and prevent complications. Stay safe DP friends!
~Aparna
