After recent reports that said blood clots are increasingly being found in COVID-19 patients, possibly leading to strokes, heart attacks and dangerous blockages in the legs and lungs, a Gregg County health official confirmed the novel coronavirus is associated with a number of other health conditions.
After the county this past week experienced its sixth coronavirus fatality, Gregg County Health Authority Dr. Lewis Browne was asked how other health conditions can lead to COVID-19-related deaths.
"COVID — No. 1 — has a whole lot of symptoms, which means it causes a whole lot of different disorders," Browne said.
All six of the Gregg County deaths have been associated with nursing homes — either a resident or worker, Browne has said.
The county’s first COVID-19 death, on May 1, was a woman in her 70s who was a local nursing home resident who died at a local hospital. The second death, on May 3, was a 73-year-old man who worked in a nursing home in another county but died in his Gregg County home. The third death, an 80-year-old woman who was a local nursing home resident, had tested positive May 1 and died May 15.
The fourth death was a 74-year-old man who was a local nursing home resident who died May 17. The fifth death was a Longview nursing home resident who had been in the intensive care unit of a hospital for a few days and who died May 24. The sixth death was a nursing home resident in her 60s. She had been had been hospitalized and died May 27.
"One of the deaths, I truly believe, was a blood clot," Browne said, "but it’s related to the COVID because we know COVID patients get blood clots."
Other conditions occur with the novel coronavirus, he said.
"It causes the arteries to get really inflamed, and blood clots can develop, and that’s one of the reason people are having problems with their hearts," he said.
"The lungs are bad," Browne said, "and blood flow to lungs is bad. The strain of these illnesses can cause a heart attack because they are just so physically stressed."
Reports have shown that even tiny clots that can damage tissue throughout the body have been seen in hospitalized patients and in autopsies, confounding doctors’ understanding of what was once considered mainly a respiratory infection.
One of those baffled is Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“I have to be humble and say I don’t know what’s going on there, but, boy, we need to find that out, because unless you know what the pathogenic (disease-causing) mechanism is, it’s going to be tough to do intervention,” Fauci said in a medical journal interview last month.
Doctors and scientists at dozens of hospitals and universities around the world are seeking answers while trying to measure virus patients’ risks for clots and testing drugs to treat or prevent them.
Some conditions that make some COVID-19 patients vulnerable to severe complications, including obesity and diabetes, can increase clot risks. But many authorities believe how the virus attacks and the way the body responds both play a role.
“COVID-19 is the most thrombotic (clot-producing) disease we’ve ever seen in our lifetime,” said Dr. Alex Spyropoulos, a clot specialist and professor at Feinstein Institutes for Medical Research in Manhasset, New York.
Clotting has been seen in other coronavirus infections, including SARS, but on a much smaller scale, he said.
Scientists believe the coronavirus enters the body through enzyme-receptors found throughout the body, including in cells lining the inside of blood vessels. Some theorize that it might promote clotting by somehow injuring those vessels as it spreads.
That injury might cause a severe immune response as the body tries to fight the infection, resulting in inflammation that also might damage vessels and promote clotting, said Dr. Valentin Fuster, director of Mount Sinai Heart hospital in New York.
It's unclear how many COVID-19 patients develop clots. Studies from China, Europe and the United States suggest rates ranging from 3% to 70% of hospitalized COVID-19 patients; more rigorous research is needed to determine the true prevalence, the National Institutes of Health said.
Prevalence in patients with mild disease is unknown, and the agency says there isn’t enough evidence to recommend routine clot screening for all virus patients without clotting symptoms, which can include swelling, pain or reddish discoloring in an arm or leg.
Some hospitals have found 40% of deaths in COVID-19 patients are from blood clots.
One woman who experienced the effects of COVID-19 blood clotting is Darlene Gildersleeve, 43, a Hopkinton, New Hampshire, mother of three children.
Gildersleeve thought she had recovered from a bout of coronavirus, and doctors told her to rest, but some symptoms were worsening. Finally, her doctor noticed her slurred speech on a video call.
She had had two strokes.
Now home and on a blood thinner, Gildersleeve gets physical therapy to improve strength and balance, and she still has some numbness and vision problems that mean driving is not allowed right now.
Doctors are unable to predict when or whether she’ll regain all her abilities.
She said health authorities “need to put out an urgent warning about strokes” and coronavirus. Not knowing the possible link “made me doubt myself” when symptoms appeared, she said.