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COVID-19: blood thinners for the prevention and treatment of thrombosis?

COVID-19: blood thinners for the prevention and treatment of thrombosis?


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Autopsies of COVID-19 deceased: Lungs and other organs damaged

The disease COVID-19 triggered by the novel coronavirus SARS-CoV-2 can not only cause severe pneumonia, but also cause thrombosis in the lungs and subsequently damage other organs such as the kidney, liver and pancreas. The benefits of blood thinners to prevent and treat these thromboses have not yet been clarified, according to researchers.

At the beginning of the pandemic, the novel coronavirus SARS-CoV-2 was often referred to as the respiratory virus. However, scientific studies have now shown that the pathogen is a “multi-organ virus” that affects many organs and often leads to thrombosis and pulmonary embolism. This is also demonstrated by post-mortem tests of COVID-19 deceased.

Multiple organs damaged

According to a recent announcement by the Medical University (MedUni) Vienna, COVID-19 not only triggers severe pneumonia, but can also cause thrombosis in the lungs and subsequently damage other organs such as the kidney, liver and pancreas.

This has been shown by the results of a first large series of autopsies in Austria, which were carried out as part of a study of the pathology of the State Hospital Graz II, West location in cooperation with the Medical University of Graz, the Johannes Kepler University Linz and the MedUni Vienna.

The study was published in the journal "Journal Annals of Internal Medicine" and received an editorial.

Damage to the lungs is the starting point of the disease

As explained by Sigurd Lax, professor of pathology at Johannes Kepler University Linz and director of the Institute of Pathology at the State Hospital Graz II, an academic teaching hospital of the MedUni Graz, COVID-19 is not a disease that damages the lungs.

The doctor carried out post-mortem tests on COVID-19 deceased and evaluated the results of the first eleven cases together with his team in Graz together with colleagues from the departments of internal medicine and anesthesiology at the LKH Graz II, the diagnostic and research institute for hygiene, microbiology and environmental medicine Med Uni Graz, the Institute for Hospital Hygiene and Microbiology of the KAGes and Michael Trauner from the University Clinic for Internal Medicine III of the MedUni Vienna and says:

"Our investigation shows that although the damage to the lungs is the starting point of the disease, the result is often thrombosis in the pulmonary circulation itself and other organs are also damaged."

Rapidly progressing failure of the lung function and circulation

Thrombosis (blockage due to blood clots), like a heart attack and stroke, can directly close vessels and lead to tissue death (infarction).

With COVID-19, inflammation occurs directly in the alveoli, but the co-reaction in the small arteries often seems to trigger blood coagulation, which in particular in patients with patients with pre-existing diseases of the cardiovascular system slows down the circulation in the lungs and consequently further Thrombosis in the lungs.

According to the experts, this leads to a rapidly progressing failure of the lung function and the circulatory system as an immediate cause of death in COVID-19.

COVID-19 also affects a number of other organs such as the kidney, liver, pancreas, adrenal gland and lymphatic system.

"We see that COVID-19 is a serious infectious disease that affects the entire organism," says Michael Trauner.

It is currently still unclear whether long-term damage to the affected organs can result from survivors of severe courses. Other reports of patients who have had COVID-19 thrombosis in the leg veins with pulmonary embolism and strokes support the fact that the increased tendency to thrombosis in COVID-19 has far-reaching effects.

Further studies necessary

The role of anticoagulants, so-called "blood thinners" in the prevention and treatment of these thromboses has not yet been clarified, since clinically treated patients are given preventive care with blood-thinning medications anyway, but these could not prevent the COVID-19-typical thromboses in the series. the intensive care physicians emphasize from the LKH Graz II.

The results of the study support the requirement of coagulation experts for a generous and timely indication for thrombosis prophylaxis - even in non-hospitalized patients.

As the communication says, further studies will need to investigate when and to what extent therapeutic blood thinning is useful depending on laboratory findings and imaging.

According to the researchers, follow-up studies are necessary to elucidate the systemic and local mechanisms in the pulmonary circulation that lead to this tendency to thrombosis in order to develop new, effective therapies. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Medical University of Vienna: Autopsies: COVID-19 causes thrombosis in the pulmonary circulation and damages other organs in addition to the lungs, (accessed: May 24, 2020), Medical University of Vienna
  • Sigurd F. Lax, Kristijan Skok, Peter Zechner, Harald H. Kessler, Norbert Kaufmann, Camillo Koelblinger, Klaus Vander, Ute Bargfrieder, Michael Trauner: Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results From a Prospective, Single-Center , Clinicopathologic Case Series; in: Journal Annals of Internal Medicine, (published: 14.05.2020), Journal Annals of Internal Medicine
  • Charuhas Deshpande, MD: Thromboembolic Findings in COVID-19 Autopsies: Pulmonary Thrombosis or Embolism ?; in: Journal Annals of Internal Medicine, (published: 15.05.2020), Journal Annals of Internal Medicine


Video: Does COVID-19 Cause Blood Clot Complications? NBC New York (May 2022).


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