COVID-19 Mystery – Body Straining to Clear Blood Clots

A Reported Incident

On April 24 of this 2020 Crisis – Dr. Hooman D. Poor, a pulmonologist in New York, was tired of seeing his patients die as of COVID 19, and it seems like another patient was slipping away.

The patient was on a ventilator, but it was not helping her anymore. Oxygen was not getting to her organs. The level of acid was rising in her blood.

Her body was in a shudder, and kidneys were failing, but the doctor could not put her on dialysis. She was moreover sick and probably would not survive it.

Dr. Hooman D. Poor was about to call her family to deliver this devastating news.

As he deliberates her lab results, he noticed that, like several other COVID-19 patients, she had high levels of protein parts called D-dimers, which are left over when the body produces blood clots. Her body was dreadfully trying, but failing, to clear blood clots, Hooman believed.

A COVID-19 Mystery

Around the globe, doctors treating COVID-19 patients have been trying to understand the same thing. When they extract blood from COVID patients, it clots in the tubes. When nurses insert hemodialysis catheters and IV lines to draw blood, the tubes become clogged rapidly.

As earlier a press release said that the “Passive immunization could save COVID-19 patients,” Dr. Tahir Shamsi said.

These COVID 19 patients are making clots all over Pakistan that is making treatment of these patients very challenging” observed by one of the best hematologists of Lifeline Hospital.

In addition to the recognized breathing problems, blood clots are also a substantial danger for COVID-19 patients.

Clots are instigating patients with COVID to have a stroke and heart attacks, forming strange red rashes on the skin and swollen wounds that look like frostbite on their toes and fingers.

On autopsy, the small vessels of the bowels and lungs, kidneys, and liver and of COVID patients are choked with clots.

A Case Study Brings The Light

Adam Cuker, a hematologist and associate professor of medicine at the Hospital of the University of Pennsylvania, gave his patient a powerful blood-thinning medication that is commonly used to treat strokes. It is risky, if misused, it can cause uncontrolled bleeding and can be fatal.

Within 30 minutes of taking the medication, his patient showed signs of improvement. Patients’ carbon dioxide levels are low, and other signs of shudder seem to be improving.

The patient lived for another week before finally dying. Adam Cuker said I tried the drug on other COVID-19 patients too. This did not help them survive, but he feels that it has shown him something about the disease.

It highlights the possibility that blood clots may play a more critical role in this disorder than we previously estimated, our hematologists said.

Lessons From The Unusual Incident

Dr. Tahir Shamsi, one of the best pathologists of Pakistan, has been performing an autopsy on patients who died with COVID-19.

So far, he has finished 20 cases and has one thing in common: He observed the full of blood clots in the smallest vessels in the body.

There, the clots appear to have reduced blood flow to the small air sacs where blood cells exchange oxygen and carbon dioxide. The lungs seem to be particularly affected.

Blood cannot flow and exchange oxygen as it should, Dr. Tahir Shamsi said.

Our hematologists say the pattern of damage is prominent.

“I have never had a series of cases like this, where everyone looks the same, and all the lungs have a similar outline. There are types of vascular lesions at autopsy that I have not been observed before. I would say it I really new, our hematologists said.

Dangerous blood clotting is a constant risk for patients with serious illnesses. This is especially true for those who freeze and mechanically ventilate devices, such as patients with COVID-19 often.

But a recent French study, comparing 150 patients with COVID-related respiratory failure who were treated in intensive care units with 145 patients with respiratory failure.

But who was not disease-ridden with the new-fangled Coronavirus, found significantly higher rates of blood coagulation in COVID patients.

Our hematologists said, we still need more controlled data. Still, based on clinical observations and the few published studies, it appears that thrombosis blood clotting is more common in these patients.

Still An Open Question

Why blood congeals the technique does in some COVID-19 patients?

One concept is that the body launches an immune attack called a cytokine storm to fight a self-targeting Coronavirus, which kills cells in an attempt to stop the infection.

The panel of Doctors in Pakistan believe that for some patients, an immune attack can cause more harm to the body than the Coronavirus itself.

This highly inflammatory condition is itself a known risk of blood clots. Cytokine storms can cause a disease called diffuse intravascular coagulation, or DIC, in which patients bleed uncontrollably and frequently clot at the same time.

Another significant possibility is that the Coronavirus may more directly cause the clotting.

New Research Is Here

A research message published this week in The Lancet reported evidence of viral antibodies against the new Coronavirus that invades endothelial cells.

The lining is the lining of blood vessels. It handles crucial functions in the vascular system, such as thrombosis and swelling.

Images captured under an electron microscope found traces of Coronavirus in the endothelial cells of the heart, kidneys, small intestine, and lung, almost throughout the body.

The researchers collected tissue while dissecting three patients who died of COVID-19.

DIP-CARD, Dr. M Arif, Cardiovascular Diseases Department at Lifeline Hospital, said that the results indicate that the virus can directly infect the lining.

He said that while COVID-19 can definitely cause respiratory problems, he does not think it is just a lung disease. Actually, it is a disease of the endothelium.

Dr. M Arif said that the infection begins in the lungs, as breathing is the prime way for the Coronavirus to enter the body.

Once it affects the lung cells and begins to destroy them, it travels to the bloodstream. There, it affects endothelial cells, causing endotheliitis.

Dr. M Arif thinks this endotheliitis not only comes from the direct infection of the blood vessel cells but also comes from the haywire cytokine storm that the body launches to fight against it.

Dr. M Arif says this theory of infection explains some things that doctors have been trying to puzzle out.

For example, conditions like high blood pressure, diabetes, and heart disease cause pressure on the lining. Not surprisingly, then, people with these conditions also develop the disease when they develop COVID-19.

It also helps explain the reason for the low blood oxygen level in patients. Still, their lungs may not be as firm as they are generally in patients suffering from shortness of breath with pneumonia.

Dr. M. Arif explains. I know that one of the results of endotheliitis is that the blood vessels cannot shrink as they usually do.

Usually, when part of the lung is damaged, the small blood vessels in that area are closed so that blood can flow to a part of the lung that is still working, where it can accumulate oxygen.

This system defends the body from a sudden drop in oxygen and appears to degrade in patients with severe COVID-19 infection. Dr. M. Arif believes that the cause is the endothelium.

The conclusion is that coagulation is a characteristic of COVID-19 syndrome. When it becomes a significant problem, the disease is very severe and advanced. For this reason, the treatment of the resulting blood clots may not work.

It is believed that something worth trying might be giving patients medications to support the lining, such as ACE inhibitors and statins, along with anti-inflammatory drugs to treat a cytokine storm early in the illness, but it is needed. More research to be sure.

If COVID-19 is really a widespread infection, Dr. M Arif believes. Knowing this also helps explain why the ventilator did not help increase the number of patients. A study of 5,702 patients hospitalized with COVID-19 in NYC found that while only 12.1% needed a respirator to help them breathe, 88.3% of these patients died.

It does not act like the flu or other bacterial pneumonia since it has inflammation in the lungs and the accumulation of fluid and very rigid lungs. It does not seem to be the case, at least early, as Dr. M. Arif said.

“The Coronavirus behaves as if its main target is the coating, Dr. M. Arif said.

It means that strokes are only part of a much bigger problem, and one of the poor says that doctors still don’t know how to solve them.

Coronavirus Reinfection And Immunity

With no vaccine or treatment yet for COVID-19, there has been an extended discussion of conducting an antibody test to observe when it might be safe to relax on the guidelines for social-distancing.

These antibody tests can reflect who has been exposed to the Coronavirus and who has not. It is essential as many people who have COVID-19 have no or mild symptoms.

The hope is that people who have already been exposed to this Coronavirus will have immunity against the virus.

When you are immune, your body recognizes the virus and control that causes COVID-19. But it is possible that people with COVID-19 get sick again and can infect the others.

Yet, LifeLine Hospital’s research team does not have the necessary information to know, which is the case. But the World Health Organization (WHO) is researching to find some of the answers.

How Can Anyone Become Immune?

When germs enter your body, the immune system begins to function. Is that how it works:

  • Bacteria and viruses like those that make COVID-19 have proteins called antigens on their surfaces. Each bacterium has its unique antigen.
  • White blood cells in the immune system make proteins called antibodies to fight the antigen. Antibodies bind to antigens the way the key fits into the lock, and destroy invading germs.
  • Once exposed to the virus, your body produces memory cells. If you are exposed to the same virus again, these cells recognize it. They tell your immune system to make antibodies against it.

Bacteria and viruses like COVID-19 contain proteins called antigens on their surfaces. Each type of germ shot works almost the same way.

It exposes your body to the antigen that trains your immune system to fight these germs in the future. Because vaccines contain weak or dead copies of the virus, you become resistant without getting sick.

Are You Immune? If You Have COVID-19

Some countries want to issue “immunity passports” to people who have antibodies against the virus that causes COVID-19, called the SARS-CoV-2 virus.

People with “passports” can return to work and travel because they are supposed to be immune to the virus.

But health experts still don’t know if we are already immune to COVID-19 after our injury. And if we are resistant, we don’t know how long it will last.

Other types of coronaviruses appear to cause some immunity. Studies show that people are protected against coronaviruses that cause colds for up to a year after infection.

Our bodies have antibodies to the coronary SARS virus for up to 4 years.

Most people who have recovered from COVID-19 produce antibodies against the virus. But so far, there is no evidence that this will protect them from the infection if they are exposed to it again.

In South Korea, more than 160 people were positive again after recovering from COVID-19. In China, between 5% and 10% of people were positive after recovering, according to press reports. It is not clear whether:

  • These people get the virus again.
  • The virus will reactivate after being noiseless for a while.
  • The test results were flawed.

Can We Be Protected By Herd Immunity?

Herd immunity occurs when a large part of the population, the herd, is immune to the virus. It can happen because these people have been vaccinated or have already been infected.

Herd immunity hinders the spread of the virus. So even those who are not sick or treated have some protection.

The more infectious the virus, the more people will need immunity to the herd’s immunity. The SARV-CoV-2 virus is so contagious that experts estimate that 70% of people in society need to be immune to protect the herd.

It can be challenging to reach this number without a vaccine, or many people get sick.

Which Test To Be Performed For Immunity?

Antibody tests, also called serum tests, measure antibodies against coronaviruses in the blood.

If you have antibodies, this means that you have been exposed to the virus and that your immune system has formed antibodies against it. Antibody tests differ from those used by doctors to verify the virus itself.

The Pakistan Food and Drug Administration. It has passed four tests to detect COVID-19 antibodies. But more than 13 companies have antibody tests on the market as mentioned earlier in the press release Government Of Pakistan For COVID-19. It is unclear how well these unsupported tests work.

Since COVID-19 is very new, there hasn’t been much time for scientists to verify the accuracy of antibody tests.

It may have false-positive results. It is when there is a positive antibody test, but you have not developed it.

Antibody tests too soon after an illness can lead to incorrect results. It takes 5-10 days after infection to develop antibodies to the SARS-CoV-2 virus.

Antibody tests can give people a false sense of security. They can return to work and start traveling again when they can still catch or spread the virus.

And because people can transmit COVID-19 to others without symptoms, false-positive results can lead to more Coronavirus outbreaks.