COVID-19 and Thrombosis: What do we know about the risks and
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Doctors are seeing high rates of blood clots in patients who are seriously ill with covid-19, but questions remain.

How common is thrombosis in critically ill patients with covid-19?:
- A recent Dutch study of 184 patients with covid-19 pneumonia admitted to an intensive care unit (ICU) found a 49% cumulative incidence of thrombotic complication. “The extent of thrombosis we are seeing with covid is extraordinary,” said researchers.

Why are covid-19 patients at particular risk of thrombosis?:
- Covid-19 causes massive inflammation boosting cytokines, which increase the liver’s production of clotting factors, For example, fibrinogen levels in a severely ill covid-19 patient are 10-14 g/L, compared with 2-4 g/L normally and 5-6 g/L in a pregnant woman.

Is thrombosis contributing to the covid death rate?:
- “Thrombosis is definitely contributing to the high mortality rate from covid,” says researchers.
- Not only can it lead to a pulmonary embolism, which can be fatal, but there are also higher rates of strokes and heart attacks.

Are the clots in covid patients different from those seen in other critically ill patients?:
- Not only high rates of deep vein thrombosis and pulmonary embolisms in covid patients are seen but also immunothrombosis with lung destruction because of inflammation is seen.

Even when the guidance comes out it will be limited, as so little research is currently available. A randomised controlled trial is desperately needed to compare the standard prophylactic dose of heparin with a standard dose in severely ill patients with covid-19.

Source: https://www.bmj.com/content/369/bmj.m2058
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HcQ is still prophylaxis for covid-19???
May 26, 2020Like1