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New Coronary Pneumonia's latest fatal accident: mysterious blood clots

New Coronary Pneumonia's latest fatal accident: mysterious blood clots


Broadway actor Nick Cordero was admitted to a intensive care unit in Los Angeles after suffering from new pneumonia. The doctor had to amputate his right leg after nearly three weeks of treatment.

A blood clot blocked the flow of blood: this is another dangerous complication caused by new coronary pneumonia. Such complications have gradually increased in the front lines of war epidemics in China, Europe and the United States.

Of course, severe patients will have "thrombosis" for various reasons, but the risk of thrombosis in patients with new coronary pneumonia is much higher than other patients.

Intensive care doctor Shari Brosnahan told that Our ICU has some 40-year-old patients with finger thrombosis. It seems that the fingers can't be saved, but there is no other reason than the new coronavirus that will cause them to amputate.

One of the patients had insufficient blood supply to both hands and feet. She estimated that amputation was inevitable, otherwise the blood vessels would be damaged too seriously and the hands and feet would also be necrotic.

Thrombosis is not only dangerous to the limbs, but also can enter the lungs, heart or brain, where they can cause fatal pulmonary embolism, heart disease and stroke.

A paper in the Dutch "Thrombosis Research" magazine found that 31% of 184 patients experienced thrombotic complications, and the researchers say this number is "extremely high"-even if there are very few extreme cases such as amputation.

Cause

Doctor Behnood Bikdeli of the New York Presbyterian Hospital assembled an international team of experts to study this complication.

Bikdeli said that the experts found that the risk was so high that patients with new coronary pneumonia "may need to receive blood thinners to prevent thrombosis" even if the patients have not undergone imaging studies.

What caused thrombosis? The answer is unclear, but he gave several possible explanations.

Patients with severe new crowns often have underlying conditions such as heart or lung disease-and this is associated with a high thrombosis rate.

Second, patients undergoing intensive care are also more likely to develop blood clots due to prolonged periods of rest.

Now we also know that New Coronary Pneumonia is also related to an abnormal immune system response called "cytokine storm"-and some studies have shown that this is also related to a higher incidence of thrombosis.

It is also possible that the virus itself causes thrombosis, which has some precedents in other viral diseases.

An article in The Lancet last week pointed out that the new coronavirus can affect the endothelial cells of organs and blood vessels. In theory, this will affect the formation of blood clots.

Microthrombus

According to Brosnahan, although blood thinners such as heparin are effective in some patients, the blood thinner is not effective for all patients because the thrombus is sometimes too small.

"There are too many microthrombi," she said. "We are not sure where they are."
In fact, autopsy revealed that some patients had hundreds of microthrombi in their lungs.

The emergence of a new puzzle actually helped solve a slightly older puzzle.

Cecilia Mirant-Borde, a intensive care physician at a veteran hospital in Manhattan, told AFP that the lungs are filled with microthrombi that explain why the ventilator does not work well for patients with low blood oxygen.

Epidemiologists will treat these patients early based on the medical protocol of acute respiratory distress syndrome (sometimes called "hydropneumonia") .

But there are some cases, "not because the lungs are full of water"-but microthrombi block the blood flow, resulting in blood oxygen content from the lungs lower than normal.

It has been almost five months since the virus first appeared, and researchers have a deeper understanding of it every day.

Although we are a little surprised, we should not be so surprised. The virus can do some incredible things,Brosnahan said.
Although the dazzling series of complications is discouraging, but there may be one or several unified principles that can explain the causes of these injuries, she said that It may be the same thing and the same solution.

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