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Relationship between COVID-19 and blood clots identified
Worldwide, COVID-19 is treated as a primary lung disease, but complications from blood clots are also repeatedly observed in people with COVID-19. This suggests that respiratory failure in COVID-19 is not solely due to the development of acute respiratory distress syndrome, but that microvascular thrombotic processes may play a role.
The University of Edinburgh's recent investigation found that microvascular thrombotic processes appear to play an important role in the development of respiratory failure in COVID-19. The results of the study were published in the English-language journal "Radiology".
Thrombotic complications in COVID-19 sufferers?
The study described the prevention, diagnosis and treatment of complications from blood clots in patients with COVID-19. Concerns about thrombotic complications have increased based on recent reports that show a strong correlation between elevated D-dimer levels and poor prognosis.
Is COVID-19 really a primary lung disease?
Worldwide, COVID-19 is treated as a primary lung disease. However, from analysis of all available current medical, laboratory and imaging data on COVID-19, it became clear that the symptoms and diagnostic tests cannot be explained by impaired lung ventilation alone, the researchers report.
Respiratory insufficiency in COVID-19 is not solely due to acute respiratory distress syndrome
Recent observations indicate that respiratory failure in COVID-19 is not solely due to the development of acute respiratory distress syndrome, but that microvascular thrombotic processes may play a role. This can have important consequences for the diagnostic and therapeutic management of those affected. The research group explains that there is a close relationship between D-dimer values, the course of the disease and features of the chest CT that indicate venous thrombosis.
The prothrombotic and thrombotic state of COVID-19 must be considered
In addition, various studies in COVID-19 sufferers have shown a very strong association between increased D-dimer levels and a serious illness or poor prognosis. The researchers emphasize that careful attention must be paid to the initial diagnosis and treatment of the prothrombotic and thrombotic condition, which can occur in a significant percentage of those affected by COVID-19.
COVID-19 syndrome gradually affects all organs in the body
Imaging and pathological studies confirmed that COVID-19 syndrome is a thrombotic inflammatory process that initially affects lung perfusion, but affects all organs of the body in succession, the researchers report. Another study came to similar results, showing that the novel coronavirus causes systemic vascular inflammation.
When is anticoagulant therapy appropriate?
This highly thrombotic syndrome leads to macrothrombosis and embolism. Therefore, strict thrombosis prophylaxis, adequate imaging monitoring with early anticoagulant therapy in the event of suspected venous thromboembolism are advisable, the researchers advise.
What measures should be taken?
Recommendations for diagnostic and therapeutic management, which vary depending on the patient's symptoms and risk profile, include prophylactic dose heparin, chest CT, pulmonary CT angiography, and routine D-dimer testing, the research group continues.
Connection between COVID-19 and pulmonary embolism?
Findings have also been made that more specifically relate COVID-19 to pulmonary embolism. When analyzing 106 pulmonary CT angiograms performed for one month in a tertiary care center in France for COVID-19 patients, 32 patients (30 percent) had acute pulmonary embolism. This rate of pulmonary embolism is much higher than usual in critically ill patients without COVID-19 infection (1.3 percent) or in emergency room patients (three to ten percent).
COVID-19 is more than a lung infection
The researchers conclude that COVID-19 affects the pulmonary vasculature and other organs and is associated with a high risk of thrombosis with acute life-threatening events that require adequate treatment. (as)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Matthijs Oudkerk, Harry R Büller, Dirkjan Kuijpers, Nick van Es, Sitse F Oudkerk et al .: Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands, in Radiology ( Published 03/23/2020), Radiology