SARS-CoV-2 increases the risk of blood clots – naturopathy & naturopathy specialist portal

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 indicates 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“Published.

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 association 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 chemical 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 suggest 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 needs to 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 and showed 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 appropriate, 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 COVID-19 patients over a one-month period in a tertiary care center in France, 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 vascular system of the lungs and other organs and is associated with a high risk of thrombosis with acute life-threatening events that require adequate treatment. (as)

Sources:

  • Matthijs Oudkerk, Harry R B├╝ller, 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 23.03.2020), Radiology

Important NOTE:
This article contains general information only and should not be used for self-diagnosis or treatment. He can not substitute a visit at the doctor.

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Secondary analysis strengthens the safety of the blood thinner

Treatment with blood thinner apixaban has been associated with a lower risk of bleeding, death and hospitalization than warfarin, regardless of the history of stroke or previous blood clot, according to a secondary analysis presented today as a science at the cutting edge in the American Stroke Association International Stroke Association Conference 2020. The conference, from 19 to 21 February in Los Angeles, is a worldwide meeting for researchers and clinicians dedicated to stroke science and brain health.

The AUGUSTUS study, first published in March 2019, found that treatment with apixaban without aspirin resulted in fewer bleeds and fewer deaths and hospitalizations than treatment with a vitamin K antagonist (such as warfarin) plus aspirin among patients with atrial fibrillation and acute coronary syndrome and / or percutaneous coronary intervention treated with a P2Y12 inhibitor. The present study is a secondary analysis of the efficacy and safety outcomes of these treatments.

We divided the population of the AUGUSTUS study into two groups: patients with previous stroke / transient ischemic attack / thromboembolism and those without stroke / transient ischemic attack / thromboembolism. Apixaban was safer than warfarin, causing less major bleeding and more effective, resulting in death or hospitalization in both groups. “

Maria Cecilia Bahit, M.D., principal author of the study, head of cardiology at INECO Neurociencias in Rosario, Santa Fe, Argentina

In the AUGUSTUS study – a global multicenter study – 4,614 patients with atrial fibrillation and acute coronary syndrome or those undergoing percutaneous coronary intervention (PCI) with planned treatment with a P2Y12 inhibitor were randomly assigned to receive apixaban or a vitamin antagonist. K and receive corresponding aspirin or placebo for six months. Of the 4,581 patients with information available on the previous stroke, 13.8% had had a previous ischemic / transient attack or thromboembolism.

This analysis found:

Previous stroke patients were at increased risk of ischemic stroke, bleeding, hospitalization or death compared to those without previous stroke;

Apixaban without aspirin has been associated with the lowest rate of bleeding, death or hospitalization, regardless of the history of previous strokes;

The highest bleeding rate was observed in patients who received the combination of a vitamin K antagonist plus aspirin;

The risk of bleeding was greater with aspirin than with placebo among patients with no previous events; is

No significant differences between aspirin and placebo were observed between patients with and without previous stroke for other clinical outcomes.

“These findings reinforce the main findings of the AUGUSTUS study by assuring clinicians that even in a high-risk group of patients with previous strokes” less is more. “In other words, an apixaban strategy plus a P2Y12 inhibitor without aspirin has the results more favorable and triple therapy – a vitamin K antagonist plus an aspirin plus a P2Y12 inhibitor – should be avoided, “said Bahit.

Source:

American Heart Association

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