https://www.cdc.gov/coronavirus/2019-ncov/hcp/underlying-conditions.html
Preprint COVID-19 presented with Deep Vein Thrombosis: An unusual case report
Disseminated Intravascular Coagulation
When you have disseminated intravascular coagulation, or DIC, the body’s blood-clotting response doesn’t work right. Abnormal clots form, which can lead to internal bleeding or organ failure.
In one study of Chinese COVID-19 patients, DIC was common among those who died.
The situation remains extremely unclear.
Patients are at high risk of arterial and venous thromboses.
Antiphospholipid antibodies have been detected in some patients.
DIC has occurred, however this may be a non-specific complication of multi-organ failure.
Vascular complications of COVID-19 are multifactorial
The vascular complications associated with COVID-19 may be due to conventional risk factors, hematological derangements, and immunological.
Whereas in adults with critical illness, the venous complications (deep venous thrombosis and pulmonary embolism)(1), or arterial complications (STEMI and ischemic stroke)(2-3) can be because of the underlying obesity, bedridden status, and vascular complications related to comorbid conditions (hypertension, or diabetes, dyslipidemia), hematological changes and immunological mechanisms may explain the cases of antiphospholipid syndrome secondary to COVID-19 (4).
However, skin lesions indicating ischemia have been described even in children (5-6). Because no skin biopsy or serological studies like ANA, cANCA, pANCA, cryoglobulins or skin biopsies have been done, it is not possible to exclude viral vasculitis or cryoglobulinemia as a cause.
1.Article Incidence of thrombotic complications in critically ill ICU ...
2. Article ST-Segment Elevation in Patients with Covid-19 — A Case Series
3. Article Neurologic features in severe SARS-COV-2 infection
4. Article Clinical and coagulation characteristics of 7 patients with ...
5. https://www.fip-ifp.org/wp-content/uploads/2020/04/acroischemia-ENG.pdf
6.Article Chilblain‐like lesions on feet and hands during the COVID‐19 Pandemic
Who is most at risk for the coronavirus disease?
For most people, the immediate risk of becoming seriously ill from the virus that causes COVID - 19 is thought to be low. Older adults and people of any age with underlying health conditions, such as diabetes, lung disease, or heart disease, are at greater risk of severe illness from COVID-19.
https://www.cdc.gov/coronavirus/2019-ncov/about/share-facts.html#:~:text=For%20most%20people%2C%20the,from%20COVID%2D19.
According to the WHO, older adults and persons with pre-existing medical conditions or compromised immune systems are at a higher risk for severe illness from the virus. This includes people who have heart disease, lung disease, cancer, high blood pressure, or diabetes.
https://healthcare.utah.edu/healthfeed/postings/2020/03/covid19-faqs.php#:~:text=According%20to%20the%20WHO%2C,pressure%2C%20or%20diabetes.
Dear Chinaza Godswill Awuchi , Muhammad Yousuf , Rajkumar Rajendram , Ijaz Durrani
if we can not stop the viral infection at this time we can minimize th death rate through treatment of risk factors or Treatment of hematological derangements, and immunological
1- Blood transfusions or packed RBCs
2- Drugs to suppress the body's immune system or promote the creation of healthy red blood cells
3- Plasmapheresis, a procedure that can remove from a person's blood the antibodies that have targeted red blood cells
4- Long-term treatments designed to resolve a person's thrombotic problems include:
a- Surgical removal of the spleen, which can destroy too many red blood cells.
b- Blood or bone marrow stem cell transplant, which replaces damaged blood or bone marrow stem cells with healthy cells from a donor.
https://www.researchgate.net/post/Are_we_wrong_in_Treatment_of_Corona
https://chemrxiv.org/articles/Flawed_methods_in_COVID-19_Attacks_the_1-Beta_Chain_of_Hemoglobin_and_Captures_the_Porphyrin_to_Inhibit_Human_Heme_Metabolism_/12120912/1
Well,
I will aid the idea of raising LMWH dose and maybe correction of AT3 to resolving thrombotic complications. I think that vascular complications are charry on the cake. The point is to classify the pts with dominant coagulation problems early in the course of illness. The idea of measuring DDimer and FI at the pts presentation is easy to perform. There are scarce data that using prophylactic LMWH is connected with decreased mortality. The problem is that many severe COVID pts have some degree of hepatic insufficiency and low AT3 levels. So anticoagulation is not efficient even in the therapeutic dose.
Dear Dr Naser Ahmed,
I was not speaking about the clearing of UFH, I was telling about LMWH giving in raised dose because of decreased AT3 (antithrombin 3 produced in the liver). The vast majority of severe ptc have procoagulant hemostasis, which is not just diagnosed with enormously raised D Dimer, FI, but also clinically with dg of acroischemia, VTE, PTE suspicion, or dg, different types of cerebrovascular and heart ischemia.
But in my opinion, the answer to the question is that everybody entering the hospital should be screened for D dimer and FI. Everybody should have ECG at admission. After that, if there is raised D dimer above 1500ng/ml, or and F1 greater than 7g/dl or less than 2g/dl should have prophylactic LMWH, and should have periodical screening of coagulation according to their general state. Other concerns should be the level of inflammation, renal and hepatic insufficiency, and of course the number of platelets.
In my conclusion,
ptc with procoagulant results at admission that are raising further and ptc with signs of raised inflammation (Le, F1, CRP, Presepsin, Il-6 probably) should be screened for the risk of vascular complications.
COVID-19 linked to cardiac injury, worse outcomes for patients with heart conditions
https://www.sciencedaily.com/releases/2020/03/200327113743.htm
Kindly follow this link on COVID-19 and Cardiology
https://www.escardio.org/Education/COVID-19-and-Cardiology
Cardiovascular complications in COVID-19
Brit Long, MD,a,⁎ William J. Brady, MD,b Alex Koyfman, MD,c and Michael Gottlieb, MDdAuthor information Article notes Copyright and License information Disclaimer
Dr Naser,
Thank you very much. Now we understand each other. Platelet function should be also revealed. But I didn`t find any study about this. Again I am talking about severe ptc.
Someone with pre-existing heart disease who becomes ill with COVID-19 may suffer a heart attack or develop congestive heart failure. This rapid worsening of cardiovascular health is likely due to a combination of the severe viral illness and its increased demands on the heart (fever causes rapid heart rate, for example), compounded by low oxygen levels due to pneumonia and increased propensity for blood clot formation. In addition to the increase in these heart problems, a more unusual condition called myocarditis has also been observed in COVID-19 patients.
High cholesterol
Diabetes
High blood pressure