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Mumbai: Covid patients can suffer from arterial thrombosis, say doctors

01:09 AM Aug 05, 2021 | Swapnil Mishra

Evidence shows that there is an association between Covid and arterial thrombosis cases as many post-Covid patients have been found suffering from limb and life-threatening blood clots in the arteries of the legs. Arterial thrombosis, induced by Covid, is said to have dire outcomes and leads to an increase in the number of amputations and deaths.

Doctors said that timely follow-up, early detection of symptoms, and prompt treatment will prevent complications and the limbs can be saved from gangrene setting in and amputation.

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A 46-year-old woman, a resident of Sion, with a past medical history of hypertension and obesity was tested Covid positive on March 21. She had fever and cough and her CT score was 8/25. Her oxygen saturation was 92%. She was then admitted to a hospital on March 27 and needed 4 litres of oxygen. She was treated with the help of steroids and remdesivir for six days.

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The patient was discharged after 10 days of oral steroids, antibiotics and ecosprin in the first week of April. Nine days after being discharged, she experienced pain in her left foot. She consulted a physician who prescribed her some pain killers. But 24 hours later, the pain got worse. The physician then referred her to an orthopaedic who advised her an arterial colour doppler, which revealed clots (thrombosis) in the main artery of her leg.

Dr. Rahul Sheth, interventional radiologist at Zen multispeciality hospital, said, they have treated 24 patients for lower limb arterial clots, of which they could save 17 limbs from being amputated. Seven patients required some form of amputation as they were diagnosed late. Out of the 24 patients, two were admitted in the first wave and 22 in the second.

“Various studies have shown that Covid leads to clots in the arteries that are responsible for carrying oxygen-rich blood to the body from the heart. This can be termed as arterial thrombosis. It is postulated that Covid increases the blood’s viscosity. When the blood flow in the artery is blocked due to the clots, there is no oxygen being supplied to the body. When this affects the legs it can lead to severe pain and cold limbs. If untreated, then it can lead to gangrene that will eventually lead to amputation. These blood clots can also travel all over the body and damage organs,” he said.

Dr. Sheth added that the symptoms will be noticeable sometimes when the person is tested positive or at times even seven to 10 days post-Covid recovery. The golden period to treat this is within 24 hours after the onset of the symptoms. Any symptoms like leg pain, pain in walking, cold limbs should not be ignored and a doctor should be consulted. Examination of the affected leg and palpation of the foot should be done. If the pulse is absent, then immediate admission should be done, followed by an arterial colour doppler.

The colour doppler is like sonography for the blood vessels to detect any blockage. Then, a peripheral angiography is performed to confirm the diagnosis and decide on a treatment plan. Two main options are endovascular, where the clots are removed using a special catheter and a clot-busting drug is given to dissolve the clots; or surgical wherein an incision is made in the artery and the clot removed using a device. Endovascular is preferred nowadays since the clots in the small blood vessels in the leg and foot can also be cleared.

“There is no awareness regarding this condition and the patients ignore early symptoms. Some come to the hospital in advance stages with discolouration of skin or gangrene. The first 12 to 24 hours is crucial as blood circulation needs to be restored. Don’t take severe leg pain or any abnormal changes in the body casually during post-Covid period,” said Dr. Sheth.

What is arterial thrombosis?

Some blood clots form in veins, often in the legs or pelvis. When this happens, it is known as deep vein thrombosis. Arterial thrombosis can cause life threatening events, such as heart attack or stroke.

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