Mysterious blood clots are killing patients
Craig Coopersmith was up early that morning as usual and typed his daily inquiry into his phone.
“Good morning, Team Covid,” he wrote, asking for updates from the ICU team leaders working across 10 hospitals in the Emory University health system in Atlanta.
One doctor replied that one of his patients had a strange blood problem. Despite being put on anticoagulants, the patient was still developing clots. A second said she’d seen something similar. And a third. Soon, every person on the text chat had reported the same thing.
“That’s when we knew we had a huge problem,” said Coopersmith, a critical-care surgeon. As he checked with his counterparts at other medical centers, he became increasingly alarmed: “It was in as many as 20, 30 or 40 percent of their patients.”
A month ago, when the country went into lockdown to prepare for the first wave of coronavirus cases, many doctors felt confident they knew what they were dealing with. Based on early reports, the novel coronavirus appeared to be a standard variety respiratory virus, albeit a contagious and lethal one with no vaccine and no treatment.
They’ve since seen how COVID-19 attacks not only the lungs but the kidneys, heart, intestines, liver and brain.
Increasingly, doctors are reporting bizarre, unsettling cases that don’t seem to follow any of the textbooks they’ve trained on.
They describe patients with startlingly low oxygen levels — so low that they normally would be unconscious or near death — talking and swiping on their phones. Asymptomatic pregnant women suddenly in cardiac arrest. Patients who by all conventional measures seem to have mild disease deteriorating within minutes and dying at home.
With no clear patterns in terms of age or chronic conditions, some scientists hypothesize that at least some of these abnormalities may be explained by severe changes in patients’ blood.
The concern is so acute some doctor groups have raised the controversial possibility of giving preventive blood thinners to everyone with COVID-19 — even those well enough to endure their illness at home. Blood clots, in which the red liquid turns gel-like, appear to be the opposite of what occurs in Ebola, Dengue, Lassa and other hemorrhagic fevers that lead to uncontrolled bleeding. But they actually are part of the same phenomenon — and can have similarly devastating consequences.
Autopsies have shown some people’s lungs filled with hundreds of microclots. Errant blood clots of a larger size can break and travel to the brain or heart, causing a stroke or heart attack.
On Saturday, Broadway actor Nick Cordero, 41, had his right leg amputated after being infected with the novel coronavirus and suffering from clots that blocked blood from getting to his toes.
Lewis Kaplan, a University of Pennsylvania physician and head of the Society of Critical Care Medicine, said that every year doctors treat people with clotting complications, from those with cancer to victims of severe trauma, “and they don’t clot like this.”
“The problem we are having is that while we understand that there is a clot, we don’t yet understand why there is a clot,” Kaplan said. “We don’t know. And therefore, we are scared.”