After actor Nick Cordero spent three weeks in the intensive care unit for the treatment of Covid-19, doctors were forced to amputate his right leg.
The 41-year-old actor’s blood circulation was affected by a hematoma.
It is the next dangerous complication of Covid-19, emerging in patients from China, Europe to the US. Such “thrombosis” occurs for a variety of reasons for special treatment patients, but the incidence among Covid-19 patients is much higher than expected.
The percentage of patients with hematoma is quite high
“I have 40-year-old patients in the intensive care unit who have hematoma in their fingers, causing them to lose their fingers, but there is no other reason than the virus,” said Shari Brosnahan, MDU doctor at the hospital. NYU Langone told AFP.
One of her patients is suffering from reduced blood flow to both hands and feet, and she thinks that an amputation of the arm or leg may be necessary, otherwise the blood vessels may be damaged to the point that the arm or leg caseation.
A hematoma is not only dangerous for limbs, but can also enter the lungs, heart and brain, causing fatal complications such as pulmonary embolism, heart attack and stroke.
A recent study from the Netherlands in the journal Thrombosis Research found that 31% of the 184 patients had thrombotic-related complications, a number that scientists say is “quite high”, despite the need for a saw. Limbs are quite rare.
Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, has set up an international team of experts to study this issue. The results of their study appear in the journal of the American Society of Cardiology.
Accordingly, the risk for Covid-19 patients is so great that patients “may need anticoagulants to prevent them,” before the scan, Bikdeli said.
The cause of the above complication is not well understood, but there are some explanations.
People with severe Covid-19 often have heart and lung disease – the disease itself has a higher incidence of hematoma.
Being in the ICU also makes patients more prone to blood clots because they sit still for too long. That’s why long-haul passengers are encouraged to stand up and relax.
In addition, Covid-19 has been shown to be associated with an abnormal immune response called “cytokine storms,” and several studies suggest this is associated with a higher incidence of hematoma.
It is also possible that the virus itself causes a hematoma. Previous viral illnesses have also recorded hematoma.
A study in the Lancet medical journal last week showed that the virus can infect the inner layer of cells and blood vessels called endothelial cells. In theory, this could interfere with blood clotting.
Specifically, according to a study in the Lancet, corona virus not only causes pneumonia but also can attack blood vessels throughout the body, leading to multiple organ failure.
“Viruses not only attack the lungs, but also attack blood vessels everywhere,” said Frank Ruschitzka, author of the study from the University Hospital of Zurich, according to the South China Morning Post.
“It invades the endothelial cell layer, which is the defense line of blood vessels, weakening the defense gland and disrupting circulation,” the smallest blood vessel, the author said.
According to Brosnahan, an ICU doctor at NYU Langone Hospital, some anticoagulants such as Heparin are effective in some patients, but not for all patients, as the hematomas may be too small. , according to AFP.
“There are too many hematomas too small,” she told AFP. “We don’t know where they are.”
Autopsy of some patients showed that the lungs had hundreds of small hematomas.
Solve the previous mystery
The discovery of this new mystery – the hematoma – helps solve an earlier mystery.
Cecilia Mirant-Borde, an ICU doctor at the Manhattan Veterans Hospital, told AFP that the lungs are full of small hematomas, which may explain why the ventilator has little effect on patients with oxygen levels. low blood.
Earlier, doctors also noted the situation of “wet lungs”, causing acute respiratory failure in some patients. But in some cases, it is not the lungs that have effusion, but small blood clots that block blood flow and the blood doesn’t carry as much oxygen as usual.
Researchers continue to know more about the impact of the virus every day.
“We were quite surprised, but maybe we shouldn’t be so surprised. Anyway, viruses often have strange effects, ”Brosnahan said.
The complications may seem complicated, but “there may be one or several common mechanisms that can describe the process in which they occur,” she said. “Maybe all are the same, and there will be the same solution.”