COVID-19 Research: New York Study Shows Many COVID-19 Patients Developing Dangerous Blood Clots In Leg Arteries
Source: COVID-19 Research Jul 17, 2020 4 years, 5 months, 1 day, 59 minutes ago
COVID-19 Research: According to emerging research reports from New York, COVID-19 is associated with life-threatening blood clots in the arteries of the legs.
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Researchers are saying that COVID-19 patients with symptoms of inadequate blood supply to the lower extremities tend to have larger clots and a significantly higher rate of amputation and death than uninfected individuals with the same condition.
One such study done by researchers from Albert Einstein College of Medicine-New York had its research findings just published in the medical journal: Radiology-The journal of the Radiological Society of North America.
https://pubs.rsna.org/doi/10.1148/radiol.2020202348
SARS-CoV-2 infections association with blood clots in the pulmonary arteries is well-established. Less is known about the virus' connection to lower extremity arterial thrombosis, a condition characterized by blood clots in the arteries that impede the flow of oxygenated blood to the lower extremities.
Radiologists at Montefiore Medical Center during the peak of the COVID-19 pandemic in New York City, observed an increase in patients testing positive for lower extremity arterial thrombosis on CT angiography exams. The patients had arrived at hospitals with coldness, pain or discoloration of their legs. Frequently these symptoms of leg ischemia, a condition in which blood flow to the lower extremities is restricted, were accompanied by respiratory distress, cough, fever and altered mental status.
This growing alarming trend prompted the researchers to look more closely at a possible connection between COVID-19 and lower extremity arterial thrombosis and whether people with the virus had a worse prognosis.
In March and April 2020, they identified 16 COVID-19-positive patients, average age 70, who underwent CT angiography of the lower extremities for symptoms of leg ischemia. These patients were compared with 32 COVID-19-negative patients, average age 71, who underwent CT angiography with similar symptoms in previous years and who were well matched with COVID-19 cohort for demographic and clinical characteristics.
In the study, all patients with COVID-19 infection undergoing lower extremity CT angiography had at least one clot in the leg, compared with only 69% of controls. The clots in the COVID-19 patients were significantly larger and affected arteries higher up in the leg with greater frequency than those in controls. Death or limb amputation was more common in the COVID-19 patients.
Study lead author Dr Inessa A. Goldman, M.D., a radiologist at Montefiore and Assistant Professor at Albert Einstein College of Medicine in New York City told Thailand Medical News, "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. 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."
It was found that COVID-19 patients presenting with symptoms of leg ische
mia only were more likely to avoid amputation or death than patients who had symptoms of ischemia and systemic symptoms including cough, respiratory distress or failure, hypoxia, fever, or altered mental status.
Dr Goldman added, "In our cohort none of the five patients presenting with complaints pertaining to leg symptoms only, such as pain or discoloration, without systemic symptoms sustained amputation or died."
She noted that with infection rates rising in many parts of the country, it is important that physicians be mindful of the connection between COVID-19 and lower extremity arterial thrombosis.
Dr Goldman said, "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.”
Dr Goldman also said that COVID-19's association with lower extremity arterial thrombosis is likely related to a combination of factors, including an increased tendency of the blood to clot, damage to the lining of the arteries, and immune reactions tied to the SARS-CoV-2 virus and COVID-19 infection.
She added, "This continues to be an area of intense study around the globe."
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