In May his year, doctors observed an increasing number of critically ill COVID-19 patients having blood clots, or thrombosis. Recently, a study directly linked coronavirus to blood clots in the leg of patients.
The recent findings published in the journal Radiology describe life-threatening thrombosis in the leg arteries. Medical experts had already established that coronavirus causes blood clots in the pulmonary arteries or the lungs, yet little is known about thrombosis in other parts of the body.
Professor Beverly Hunt from the charity Thrombosis UK explained, "The issue with Covid-19 is that the blood is incredibly sticky. This stickiness is causing them to have deep vein thrombosis. And of course, if you have a deep vein thrombosis, bits of it can break off and travel through your body and block some of the blood supply to the lungs."
When New York City was the epicenter of the pandemic, radiologists from the Montefiore Medical Center observed that more patients had leg blood clots or lower extremity arterial thrombosis. These coronavirus-positive patients had discoloration, pain, and coldness in their legs.
Leg Ischemia in Coronavirus Patients
The symptoms of leg ischemia were present in those who were critically ill with fever, respiratory distress as well as an altered state of mind. Leg ischemia is the result of a lack of blood supply which reduces blood flow and oxygen levels in the lower extremities.
Between March and April, 16 COVID-19 patients underwent computed tomography (CT) angiography where the X-rays would show the condition of their blood vessels and how severe the leg ischemia had developed. Compared to 32 patients with leg ischemia but without coronavirus, the ones with the virus had much larger blood clots.
COVID-19 patients had clots affecting arteries on the upper legs. Their leg ischemia also resulted in more deaths or limb amputations than patients without coronavirus.
"We found that arterial thrombosis associated with Covid-19 infection was characterized by dire outcomes, namely strikingly increased rates of amputation and death, which in our series were 25% and 38%, respectively," said Dr. Inessa A. Goldman.
"For comparison, the rate of both amputation and death was only 3% among controls. It is unclear whether the patients' concurrent COVID-19-related pneumonia, the virulence of the COVID-19-related clotting disorder or delayed initial arrival to the hospital contributed to these outcomes."
Coronavirus and Blood Clots
Dr. Goldman explained that coronavirus patients with only leg ischemia symptoms did not die or get a limb amputation compared to those who had thrombosis with systematic symptoms. She also urges physicians to be mindful of the association between the virus and leg ischemia.
"Awareness of lower extremity arterial thrombosis as a possible complication of Covid-19 infection is important for all providers who take care of these patients because early diagnosis is usually crucial for limb preservation in lower extremity ischemia," she said. "This continues to be an area of intense study around the world."
Most likely, coronavirus being linked to lower extremity arterial thrombosis may be the result of several causes, said Dr. Goldman. An increased tendency for blood clotting, damaged artery lining, and various immune reactions to coronavirus infection may add to the complications of thrombosis.
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