The Oklahoman

Rise in limb-threatenin­g blood clots during COVID-19 crisis

- By Mario Ariza Sun Sentinel

FORT LAUDERDALE, Fla. — Health experts are now encounteri­ng a rare and terrifying COVID-19 complicati­on: plug-like blood clots in the limbs of coronaviru­s victims that strangle circulatio­n.

And that means you could lose a limb to COVID-19, even if you don't lose your life.

After querying 10 major hospital networks in Florida, the South Florida Sun Sentinel has found 26 previously unreported examples of these corona viruscause­d limb clots. These clots contribute­d to the death of at least six of the patients who had them.

And in at least one instance, surgeons at the University of Miami report having to amputate the leg of a Miami-Dade man in his mid-50s who lost circulatio­n to the limb after contractin­g the virus.

Health laws bar the release of more informatio­n about the man who lost his leg, and data is scarce on amputation­s in Florida since the pandemic started. A spokesman for Florida's Agency for Health Care Administra­tion, which keeps track of amputated limbs, says they don't expect to have clear statistics about amputation­s until April next year because of the way that hospitals report data on the procedure.

And doctors say they still don't understand how or when or why the virus causes these clots.

“We still don't know what … it does,” Dr. Mohammad Abdallah, a vascular surgeon with Broward Health, said of the virus.

But the story of how David Guerrero, an otherwise healthy 48-year-old Fort Lauderdale airport worker, almost lost his right leg to the virus serves as a chilling reminder of the potential costs of our learning curve with this new disease.

Guerrero wasn't even sure if he had COVID-19 when he started losing feeling in his right foot.

During the third week of July, he “started to feel pins and needles” in his extremity.

Three weeks earlier, Guerrero — who doesn't smoke and doesn't have any preexistin­g conditions — had come down with what he thought was a bad stomach bug. But the gastrointe­stinal symptoms persisted for a suspicious­ly long time. His doctor recommende­d a COVID19 test, but the results hadn't come back yet when Guerrero's foot started to go numb.

Soon, Guerrero couldn't walk. It was the weekend, so he tried to hold off on calling the doctors, but the pain became unbearable.

“I tried to sleep, I took a hot shower, I felt terrible. Man, I felt terrible,” he said.

So Guerrero checked himself into the emergency room at Broward Health, and that's when medical profession­als told him he was in danger of losing his leg.

“There was no blood getting into his foot,” said Abdallah, who was Guerrero's vascular surgeon. He and his medical partner, both vascular surgeons with Broward Health, have seen at least six patients with limb-threatenin­g clots related to COVID-19 since the start of the pandemic.

Abdallah suspected COVID1 9 was t he c ul pri t behind Guerrero's clot, and while he was in the emergency room, Guerrero's coronaviru­s test came back positive, almost two weeks after he took it. An X-ray showed also showed evidence of infection in Guerrero's lungs.

“His chest X-ray was classic for COVID,” Abdallah said.

Abdallah decided t o put Guerrero on powerful intravenou­s blood-thinners to try to bust the clots. But after three days of blood thinners did nothing to the clots, Abdallah told Guerrero they were going to have to go in and bust the clots by hand.

“At this point he didn't have much to lose. His limb was going to go if we left it alone, and if we intervened there was a possibilit­y he'd keep it.” Abdallah said.

What the vascular surgeon found inside the arteries of Guerrero's leg surprised him.

“It was like a plug almost,” Abdallah said of the hard, black clots he removed by hand. “It was pretty extensive.”

 ?? ALLERGY AND INFECTIOUS DISEASES VIA TRIBUNE NEWS SERVICE] ?? This transmissi­on electron microscope image shows SARS-CoV-2, the virus that causes COVID-19, isolated from a patient in the U.S., emerging from the surface of cells cultured in the lab. [NATIONAL INSTITUTE OF
ALLERGY AND INFECTIOUS DISEASES VIA TRIBUNE NEWS SERVICE] This transmissi­on electron microscope image shows SARS-CoV-2, the virus that causes COVID-19, isolated from a patient in the U.S., emerging from the surface of cells cultured in the lab. [NATIONAL INSTITUTE OF

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