One of the many issues that we’re discovering about COVID-19 is the way it may cause an elevated tendency of the blood to thrombose or clot. Apart from the veins, it has been seen that Covid additionally will increase danger of clots in arteries known as as arterial thrombosis. These clots can block the blood circulation in the extremities main to gangrene with amputation or removing of the limb as the solely selection to save lifetime of the affected person. These blood clots may journey throughout the physique and wreak havoc on distant organs.
How are these clots fashioned, what can it lead to, and what’s the therapy obtainable? Dr Raghuram Sekhar, marketing consultant, vascular and endovascular surgical procedure, Kokilaben Dhirubhai Ambani Hospital solutions all of your questions.
What is COVID-19 associated arterial thrombosis?
While it was identified that COVID an infection can lead to clots in veins, over the previous couple of months there have been instances of clots forming in arteries that carry oxygen-rich blood to our physique from the coronary heart). This is referred to as ‘arterial thrombosis’. When the blood movement in the artery will get blocked by the clots, the oxygen provide to our physique elements is reduce off main to gangrene. If not handled in time, it might lead to amputation of the limb. I’ve handled over 35 COVID sufferers with these blood clots in the limbs throughout the pandemic. In the second wave, I’ve seen instances in youthful individuals beneath 32 years of age. These gangrenous blood clots are aggressive and tough to deal with.
What is cause for clot formation?
Studies point out that COVID-19 an infection leads to a rise in the viscosity of the blood. The blood thickens, which in flip leads to formation of clots. The precise trigger for the thickening of the blood has not but been recognized.
Does this occur solely when the affected person is Covid constructive?
No. In majority of the instances, the signs make themselves seen solely 2-3 weeks after recovering from COVID, when the sufferers are discharged and in the consolation of their very own dwelling. This can lead to the signs being missed by the sufferers main to delay in therapy. Hence, it is crucial to perceive the signs offered by COVID arterial thrombosis.
What are the signs of Covid arterial thrombosis?
There are 5 early indicators of COVID-19 associated arterial thrombosis that one ought to concentrate on, which may be outlined by 5 ‘Ps’. The first P is for ‘pain’ in the limbs whose depth step by step grows over time rendering the affected person in excessive ache. The second symptom is ‘paresthesia’, which is numbness is the fingers and toes. The third P stands for ‘paralysis, where we lose movement in our limbs. The penultimate P called ‘pallor’, is paleness due to lack of blood provide, which then progresses to the limbs turning blue or black over time. Pallor paired with coldness is considered one of the first indicators of gangrene settling in. At this level it’s virtually inconceivable to really feel the ‘pulse’ on the extremities, which is the fifth symptom. For a COVID affected person who has recovered, it’s paramount to concentrate on these signs as, if caught on time and handled appropriately the affected person may be utterly cured of the illness.
When ought to a affected person go to the physician if these signs happen?
The ‘golden period’ to deal with this illness is the first 6-8 hours after the signs are seen. During this time, if the affected person consults a vascular surgeon, the therapy may be instituted and the limb saved.
How is the situation recognized?
In most instances when a affected person arrives at a hospital with these signs, a vascular surgeon will study them and carry out a process known as ‘vascular doppler’. This shade doppler is actually a sonography for the blood vessels to present the blockage. Post this process, an angiography is required in most instances. Just like when an angiography is carried out on the coronary heart for a heart-attack, a peripheral angiography is carried out on the limbs in the case of arterial thrombosis. This helps the vascular surgeon to deduce the severity of the clots and kind a therapy plan.
What is the therapy for Covid arterial thrombosis?
If the affected person has arrived at the hospital at an early stage, i.e., inside 8 hours to a most of 24 hours, the clot might not have hardened totally. In such instances, thrombolysis or thrombosuction may be carried out throughout the angiography itself, the place medicines and prescribed chemical substances are despatched by the blood vessels to dissolve the clots.
At occasions, the affected person might arrive late and by this time, the clots have hardened and can’t be handled by thrombolysis. This then requires an open surgical procedure, with sufferers below full anaesthesia and incisions made to attain the clot in the vessels. The process is known as Embolectomy. This can be fairly success, if the affected person comes to the hospital inside the first 1-2 days.
Thus, if recognized on time, the limbs may be saved from gangrene setting in and amputation.
To sum issues up, sufferers should be well-informed and well-read about the signs of arterial thrombosis, whereas actively making these round them conscious of the similar. I’ll emphasize once more that as quickly as the signs begin displaying, one should seek the advice of a vascular surgeon/ facility at the earliest to keep away from gangrene and amputation and proceed to stay a full and wholesome life.