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Blood clotting concerns in COVID-positive patients

Dangerous blood clots pose a perplexing coronavirus threat
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NORFOLK, Va. - Classified as a respiratory disease, COVID-19 is also taking aim at our body's blood vessels.

Physicians and researchers across the country have been studying a connection between the two since the virus first began circulating.

"[You may be most familiar with cases in New York where] people have actually lost legs from small vessel clots in arteries. [We've seen that in] really advanced COVID-19 patients," said Dr. David Dexter, a vascular surgeon at Sentara Healthcare.

Dexter said since the pandemic started, doctors have seen a significant number of severe COVID-19 patients develop blood clots.

"Not only do we see increased clotting disorders, we also see increased bleeding disorders, making this a much harder challenge for us clinically," he said.

Knowing this, local healthcare providers have changed their approach to treatment. People who are sick enough to go to the hospital are now proactively given blood thinners.

This was the care taken for some patients previously, but it has slowly become standard across Sentara hospitals.

"A typical scenario is that a patient comes in with some shortness of breath, they’re tested in the emergency department and are COVID-positive. They are going to go to an appropriate level of care in the hospital and get the best treatment we can offer them based on whatever modern science is telling us to do," Dexter said.

While there are still a lot of unknowns surrounding the coronavirus, local physicians have said they're learning more each day to better understand it.

Paul Merik, a professor of medicine and Chief of Pulmonary Critical Care at Eastern Virginia Medical School, said there are three fundamental problems to COVID: "inflammation, decreased oxygen and increase for clotting."

He said for severe patients in the hospital, these things can be monitored, but for those undergoing quarantine at home, it's not as simple.

"The more difficult question is, 'What do you do with patients that are mildly symptomatic at home, because they too have an increased risk of clotting?'" Merik said.

It can be especially dangerous and difficult to track when symptoms don't appear right away and can stick around for weeks.

Although not proven, Merik suggests taking aspirin, getting daily movement and keeping an eye out for potential clots.

"This is a serious disease [and] we can't minimize how dangerous this disease is," he said.

Dexter echoed that and also emphasized how it important it is that people take blood clotting seriously.

"I think the takeaway from this is that COVID is now bringing more interest to a disease process that is vitally important in American healthcare," he said. "I think it's about information sharing - talking about patients early [and] making sure people are getting the best of what they need."