A few days ago it was published that someone who had passed the had been admitted again for presenting thrombi in the leg and lungs. And it is that it is a fairly frequent sequel among patients who have spent time in bed, and who have overcome a serious picture of
Pablo Demelo Rodríguez, a specialist in Internal Medicine at the Gregorio Marañón General University Hospital (Madrid), explains that the risk of thrombosis after having been infected with the new coronavirus SARS-Cov-2 is greater in patients who have been hospitalized for many days, especially in those who have been admitted to intensive care units. He also says that older patients and those who have a history of thrombosis are more at risk.
“On COVID-19 infection we do not know exactly how long this risk of suffering thrombosis is maintained. But we know from other infectious diseases that patients who have been admitted have a higher risk of suffering thrombosis during admission, and this risk decreases progressively in the following 2 months, until it returns to normal”, explains Dr. Demelo.
It is for this reason that most of the patients admitted with COVID-19 receive theparin (anticoagulant) treatment in hospitalin order to prevent thrombus formation. “Once at home, it is important that they walk daily whenever possible. Moving and contracting the leg muscles is the best way to prevent thrombosis,” advises the Internal Medicine expert.
The risk
In this sense, the president of the Spanish Society of Cardiology, doctor Ángel Cequier, warns that a thrombus or blood clot, depending on where it forms, can cause major disorders such as heart attacks, strokes and pulmonary embolism. “When it clogs a main artery or vein, everything that it supplies is without circulation and then it becomes necrotic, it dies,” he points out.
This can be suspected, according to the Internal Medicine specialist at the Gregorio Marañón General University Hospital, based on these two manifestations of venous thromboembolic disease (VTE): With the formation of thrombi in leg veins (what we call deep vein thrombosis) or with the migration of these thrombi from the legs to the lung (what we call pulmonary embolism). A patient may have only deep vein thrombosis, only pulmonary embolism, or both at the same time, he adds.
“The symptoms of deep vein thrombosis are generally easy to identify: The patient suffers from pain and swelling of one of the legs, which sometimes also becomes red and hot. Normally it affects only one leg and the other is normal, which makes it easier to identify. This swelling of the leg can be in the calf-ankle area, but the entire leg can also swell,” he underlines.
The symptoms of pulmonary embolism are different, as Dr. Demelo warns, the most common is that the patient suddenly experiences shortness of breath, sometimes accompanied by chest pain. “Other symptoms such as a sudden loss of consciousness or rapid pulse may appear. A patient should see a doctor if they have a suddenly swollen and painful leg. They should also go if they experience shortness of breath, chest pain, or a sudden loss of consciousness,” Add.
Specifically, in the COVID-19 scenario, 80% of thrombi occur in the venous system and are usually generated in the lower extremitiesor already in the lung, in the pulmonary artery or in its branches, specifies the president of the Spanish Society of Cardiology.
This happens because the virus produces an inflammatory state in its most serious phases, as the cardiologist points out, that activate coagulation mechanisms that favor the formation of thrombi. “In the most acute phase, where pneumonia is complicated, an inflammatory response of the organism is produced in response to that infection, and for which lesions can be produced in the walls of the veins and arteries. If we add to this the prolonged patient bedridden, there is that potential risk of clotting. It is also associated with the advanced age of the patient, as well as comorbidities that also favor this imbalance in the body and the formation of clots,” he adds.
The Gregorio Marañón expert adds here that the risk of suffering a thrombosis during a hospital admission decreases progressively during the following 2 months and, for all this, he defends that it is important that patients with COVID (and the general population) maintain an active life, walking and moving their legs whenever possible.
anticoagulants
Finally, the president of the Spanish Society of Cardiology insists that not all people who have overcome COVID will be at risk of thrombus formation. “These complications that arise after the infection that do not appear in all patientsYes, in the most complex ones, and for this reason we anticoagulate those most at risk at the time of admission. We know why they occur and a treatment is being offered that empirically suggests that we are going in the right direction”, says Dr. Cequier.
In fact, a study led by the director of the National Center for Cardiovascular Research (CNIC) in Madrid and the Monte Sinai Cardiovascular Institute in New York (United States), the Spanish researcher Valentín Fuster, has recently been published, confirming that Anticoagulants May Improve Survival of COVID-19 Patientsby preventing the aforementioned possible fatal events and related to severe coronavirus pictures.
“It is important emphasize that thrombosis after hospital admission is not unknown. It has been known for many years. The circumstance occurs that in a very short time we have had thousands of patients with COVID admitted, and this added to the fact that people have hardly left home in weeks, favors that we are seeing some cases of thrombosis now, but nothing alarming “, adds Dr. Demelo.
As highlighted, the key is to prevent coronavirus infection with hand washing, social distancing, and the use of a mask when indicated. “And if we are unlucky enough to have a COVID infection, then we must try to prevent thrombosis: walking and moving our legs is the most effective method, and it is also cheap,” says the specialist in Internal Medicine at the Gregorio Marañón Hospital in Madrid. .