An overwhelming amount of medical evidence has been published in science and medical journals which are taking the medical community by storm with groundbreaking medical studies published by doctors since the beginning of COVID-19 speading across the world since December 2019, to the date of this article, the 7th of June 2020.
Doctors in direct contact with patients in emergency units in hospitals all over the world have been publishing hundreds of scientific peer reviewed journals reporting clear evidence that patients with acute symptoms of COVID-19 are displaying severe thrombosis symptoms and should be treated as such.
The COVID-19 pandemic has brought unique challenges to scientific research and has been a medical Earthquake that has shaken up not only Doctors and hospitals but also the world of medical journals along with many research institutions and teams. The fast accumulating discoveries also means there are a backlog of science journals waiting to be published that have not yet reached mainstream media or been noticed by government health advisors who are hyperfocused on vaccines, which is puzzling when there are so many of them in the Medical Scientific Journal currently advising safe and mostly successful treatments.
Evaluation of the earliest Wuhan patient data suggests that the coagulopathy with COVID-19 is a result of the inflammatory response to SARS-CoV-2 infection resulting in thromboinflammation and driving thrombosis
These Medical findings have been learned in ICU emergency units on the frontline by doctors all over the world, from China, to the US to the Netherlands, Germany, Canada, India, UK, Italy, Pakistan, Russia etc. However, presently as governments are not highlighting these findings and seem to be focused on vaccine production, meanwhile, present lives could be saved with following the current medical consensus, which is to treat COVID-19 patients in critical condition for Thrombosis and Inflammation.
The results correlate that the high incidence of thromboembolic events in these patients, suggests an important role of COVID-19–induced coagulopathy. This means it causes disseminated intravascular coagulation swelling of veins, tissue and cell damage, and bleeding. This condition affects the lungs primarily because they become inflamed. However, the inflammation extends to other organs in the body, such as the liver, kidneys, heart and the infection induces thrombosis through a complex but well-known pathophysiological mechanism. Consequently, this can cause pneumonia like symptoms, heart attack, stroke and many other thromboembolic related diseases.
A recent medical journal published on this was in the Journal of Thrombosis Research, where eleven doctors contributed to the study. Doctors from the Netherland performed studies on 184 patients with proven COVID-19 pneumonia, of whom 23 died (13%), 22 were discharged alive (12%) and 139 (76%) were still on the ICU on April 5th 2020. All patients received at least standard doses of thromboprophylaxis.
Their findings concluded that 31% incidence of thrombotic complications in ICU patients with COVID-19 infections is remarkably high. Reinforcing the recommendation to strictly apply pharmacological thrombosis prophylaxis in all COVID-19 patients admitted to the ICU, and are strongly suggestive of increasing the prophylaxis towards high-prophylactic doses, even in the absence of randomized evidence.
”The 31% incidence of thrombotic complications in ICU patients with COVID-19 infections is remarkably high. The findings reinforce the recommendation to apply pharmacological thrombosis prophylaxis in all COVID-19 patients admitted to the ICU, and are strongly suggestive of increasing the prophylaxis towards high-prophylactic doses, even in the absence of randomized evidence.”
COVID-19 may predispose to both venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilisation and diffuse intravascular coagulation.
One important autopsy study was funded by the University Medical Center Hamburg-Eppendorf, Germany in which 27 Doctors contributed to the findings. Doctors performed autopsies on patients who had COVID-19 written as cause of death on their death certificates. Autopsies were performed at a single academic medical center, as mandated by the German federal state of Hamburg for 12 patients who died with a polymerase chain reaction–confirmed diagnosis of COVID-19. Complete autopsies were performed, including postmortem computed tomography and histopathologic and virologic analysis. Clinical data and medical course were evaluated.
According to the Results ”Median patient age was 73 years (range, 52 to 87 years), 75% of patients were male, and death occurred in the hospital (n = 10) or outpatient sector (n = 2). Coronary heart disease and asthma or chronic obstructive pulmonary disease were the most common comorbid conditions (50% and 25%, respectively).
”Autopsy revealed deep venous thrombosis in 7 of 12 patients (58%) in whom venous thromboembolism was not suspected before death; pulmonary embolism was the direct cause of death in 4 patients. Postmortem computed tomography revealed reticular infiltration of the lungs with severe bilateral, dense consolidation, whereas histomorphologically diffuse alveolar damage was seen in 8 patients. In all patients, SARS–CoV-2 RNA was detected in the lung at high concentrations; viremia in 6 of 10 and 5 of 12 patients demonstrated high viral RNA titers in the liver, kidney, or heart.Postulating that COVID-19 is a vascular and hypoinfammatory disease has important implications for ongoing research. However, more evidence is needed to explore vascular injury through biomarkers, imaging, and histology. If COVID-19 is indeed primarily a vascular disorder, early invasive mechanical ventilation should be initiated cautiously. Investigations should examine the impact of liberal versus restrictive invasive mechanical ventilation strategies.”
Treating severe symptoms in patients with Coronavirus disease, means doctors should be treating patients for chronic thrombotic disease, both in the venous and arterial circulations, due to excessive inflammation, platelet activation, endothelial dysfunction, and stasis.
Over 45 doctors from all over the world contributed to the Journal of the American College of Cardiology, another recent publication, on ‘‘COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up’. The evidence is accumulating that this is the conclusive modality for treating chronic symptoms of COVID-19 patients, hopefully rather than focusing on vaccines governments will consider supporting these concrete findings by funding available technology to care for patients without COVID-19 who have thrombotic disease caused by COVID-19.
Finally, while global medical journals are exponentially publishing similar findings- Medical Doctors advise that patients need prevention or care for their thrombotic disease during the COVID-19 pandemic. Further suggestions are that Doctors should treat the chronic stages of this disease with anti-inflammatory therapies and medicines, read here some of these recommendations from doctors who have successful experience treating patience successfully with such treatments.
by Carlita Shaw
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Scientific Medical Journal References
- Thrombosis Research, Volume 191, July 2020, Pages 145-147
- Annals of Internal Medicine. Original Research-6 May 2020
3. Thieme Medical Journal –COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure
5. Intensive Care Medical Journal – Facing COVID-19 in the ICU: vascular dysfunction, thrombosis, and dysregulated
infammation by Daniel E. Leisman, Cliford S. Deutschman and Matthieu Legrand* 2020 Springer-Verlag GmbH Germany, part of Springer Nature
6. ”COVID-19 and its implications for thrombosis and anticoagulation” in the medical journal Blood
7. The Journal of Thrombosis and Haemostasis Pathological evidence of pulmonary thrombotic phenomena in severe COVID‐19 Volume18, Issue6. June 2020. Pages 1517-1519. International Society on Thrombosis and Haemostasis
8. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Journal of Translational Research, April, 2020
9. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up Journal of the American College of Cardiology April 2020
10. Arentz M, Yim E, Klaff L, et al. Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State.
JAMA. 2020;10.1001/jama.2020.4326.
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