COVID19 and blood clotting

[Bletchleyite]

Moderator note: Split from

UK face coverings discussion

As face coverings are now mandatory in most public indoor settings from today in most of the UK, this thread has been set up to continue the general discussion of this issue. thanks

www.railforums.co.uk

Given that coronavirus of this type are not new, the medical profession is likely to have spotted any pending problems by now.

As none of the others cause blood clotting problems, I think it's a bit off to suggest that that is the case.

 

[DB]

As none of the others cause blood clotting problems, I think it's a bit off to suggest that that is the case.

So what?

Really, how high are the chances that someone recovers with no ill effects then suddenly some new effect appears a year or two later? It's hardly common in any type of viral disease, is it!

 

[Bletchleyite]

So what?

Blood clotting is very serious indeed. I'm having some treated at the moment (not COVID related). They can kill.

This alone makes COVID much, much more serious than any other known coronavirus.

 

[DB]

Blood clotting is very serious indeed. I'm having some treated at the moment (not COVID related). They can kill.

This alone makes COVID much, much more serious than any other known coronavirus.

yes, but they are part of the actual infection, not a random symptom which appears months or years later.

 

[AdamWW]

Really, how high are the chances that someone recovers with no ill effects then suddenly some new effect appears a year or two later? It's hardly common in any type of viral disease, is it!

There are cases being reported of people getting over Covid-19, but then symptoms coming back worse than before. (Perhaps rare - I'd like some numbers). It's not hard to imagine with something that can affect so much of the body that it could be doing damage that isn't immediately obvious. The medical profession certainly isn't dismissing the idea.

And chronic fatigue syndrome has been linked to viral infections.

 

[Bletchleyite]

And chronic fatigue syndrome has been linked to viral infections.

Respiratory illnesses often cause adult-onset asthma, too. Lots of nasty possibilities. But the blood clotting is the most worrying one - misplaced clots can cause death, permanent damage to the heart and lungs, failure of internal organs and stroke. This is a very, very nasty aspect of COVID, and one that has convinced me (even before I had my present ones discovered) that it is much more than just a rotten cold.

 

[A Challenge]

Respiratory illnesses often cause adult-onset asthma, too. Lots of nasty possibilities. But the blood clotting is the most worrying one - misplaced clots can cause death, permanent damage to the heart and lungs, failure of internal organs and stroke. This is a very, very nasty aspect of COVID, and one that has convinced me (even before I had my present ones discovered) that it is much more than just a rotten cold.

Most of the long term problems that have been identified (so far, it could be argued) have been among people who have, if not been on a ventilator, at least been hospitalised, implying that people getting COVID-19 isn't too much a problem for the vast majority of people who don't end up in hospital as they haven't had a severe infection.

This could probably do with a new thread

 

[AdamWW]

This could probably do with a new thread

And lo, it came to pass.

Some interesting information in this article, including:

Possibly the most important of these trends is the risk of cardiac complications. It is clear that Covid-19 has the potential to cause acute cardiac problems, in particular myocarditis, which has also been recognised with previous coronaviruses such as the one causing Middle East Respiratory Syndrome (MERS).
...
We have proxy data showing cardiovascular complications from other respiratory illnesses. A 2015 study of more than 20,000 patients found that there was an increased risk of cardiovascular disease in the group who had been admitted for pneumonia over the control group, taking into account obvious confounders. The increased hazard ratio persisted for two years in one cohort studied and 10 years in the other.

In other words there is evidence suggesting that other respiratory illnesses can cause long term effects that take time to become apparent.

 

[adc82140]

Anyone who is ill enough to be on a ventilator for an extended period will have long term complications, no matter what the cause of them being in hospital. It seems that people are now scraping around trying to find other reasons to get in a panic.

I'll tell you another big cause of blood clots- having a hip replacement. I don't see anyone trying to whip up panic over that.

 

[Bletchleyite]

Anyone who is ill enough to be on a ventilator for an extended period will have long term complications, no matter what the cause of them being in hospital. It seems that people are now scraping around trying to find other reasons to get in a panic.

I'll tell you another big cause of blood clots- having a hip replacement. I don't see anyone trying to whip up panic over that.

I think you're misunderstanding. We aren't talking about clots caused by being bed-ridden - these are well known about, and often people take anticoagulants in those situations to reduce risk - we're talking about COVID causing the body to have an increased tendency to clot. That's rather different and rather more serious.

 

[adc82140]

Then treat with anticoagulants if the risk factor is high. It's still nothing to stir up panic about.

 

[MikeWM]

I was discussing this back in April with someone or other (not on here). I remember there was speculation that the virus 'knocked out' iron from the red blood cells - which had implications for treatment (eg. that it should be treated more like someone suffering from altitude sickness rather than someone with failing lungs - ie. ventilation should be avoided in general). And I think there was therefore some implication on clotting.

I was interested at the time because there was a suggestion that Diamox may be a good treatment, and that's a medicine I've taken before (and has rather nasty side-effects).

I don't seem to have seen much on any of this since, so I don't know what became of all those ideas.

 

[AdamWW]

Then treat with anticoagulants if the risk factor is high. It's still nothing to stir up panic about.

Who is stirring up panic?

 

[adc82140]

Blood clotting is very serious indeed. I'm having some treated at the moment (not COVID related). They can kill.

This alone makes COVID much, much more serious than any other known coronavirus.

Who is stirring up panic?

That's your answer.

 

[AdamWW]

That's your answer.

Ah.

OK.

We have different views on what constitutes stirring up panic then.

 

[Bletchleyite]

Ah.

OK.

We have different views on what constitutes stirring up panic then.

Agreed. Understanding, and not ignoring or downplaying, the risks posed by a disease is not "stirring up panic", I see it as "properly assessing risk".

Blood clotting inside the blood vessels is a very dangerous condition and can cause, among other things, stroke, heart failure and death through hypoxia. Not your typical bad cold or flu.

 

[adc82140]

See there you go again. These cases are outliers, extremely rare. 99. 9% of people who have had Covid will not get blood clots.

 

[MikeWM]

I've finally heard (second hand, but reliable) of someone who actually had a very bad case in late February, bad enough to be on a ventilator. Don't know for how long, or how long a recovery was required, but he's well and back to normal now.

That's my random anecdote of the day

 

[OhNoAPacer]

See there you go again. These cases are outliers, extremely rare. 99. 9% of people who have had Covid will not get blood clots.

Would love to see the scientific paper that supports that statistic. This is a novel disease and what the exact issues are, short, medium and long term, and for which severity of the illness is not yet fully known.

 

[Yew]

This is a novel disease and what the exact issues are, short, medium and long term, and for which severity of the illness is not yet fully known.

Indeed, but consistently presuming the worst across the board takes us into very statistically unlikely grounds, and when we consider the cost of mitigation, we run the risk that we're causing more harm than we're preventing.

 

[AdamWW]

Indeed, but consistently presuming the worst across the board takes us into very statistically unlikely grounds, and when we consider the cost of mitigation, we run the risk that we're causing more harm than we're preventing.

Or we could look at what data we have available to make the best decisions we can.

Which so far as I can see is what the medical profession is, on the whole, doing.

I'm not saying that medicine gets everything right because I don't think it does, partly due to lack of knowledge, partly due to humans being irrational and probably partly due to vested interests.
But I do think they understand the idea of balancing risks.

 

[yorkie]

But I do think they understand the idea of balancing risks.

I think it's easy for you to say that but the reality is rather more complex.

Different people have different ideas regarding balancing risk; also medical experts are likely to give a medical recommendation not based on economic, or other, factors.

If we are going to get into a detailed debate about assessing risk it does need to be in a different thread though; perhaps https://www.railforums.co.uk/threads/has-the-covid-crisis-changed-our-attitude-to-risk.206012/ is suitable?

Going back to @Bletchleyite's point, I think his point is that he is at increased risk due to the blood clotting treatment. I'd guess that the increased risk might apply to other viruses, too. Thinking logically, if you are experiencing a medical condition regarding blood clotting, then any other risk effectively becomes a bigger risk.

So I can understand why people who are in a higher risk situation may wish to take extra precautions, but arguably that could apply to other situations too, and not just the risks from potentially getting Covid19.

Or perhaps there was another point that I'm missing, but I've not seen a detailed explanation so it is difficult to be sure.

 

[OhNoAPacer]

The issue is that Covid19 appears to not be just a respiratory disease, it affects other body organs and is associated with blood clots and risks of strokes.
Medically it is a really nasty piece of work that from what I have read has shocked the medical profession with some of the nasties it visits on patients.
Even some who seem to have had a mild illness are left with with some form of post viral fatigue.
Of course a balance has to be struck between the purely public health response and the wider effects on society but for that balance to work people, not just the vulnerable, need to take sensible precautions to reduce the chances of transmission.

 

[furlong]

The issue is that Covid19 appears to not be just a respiratory disease, it affects other body organs and is associated with blood clots and risks of strokes.

See this article from 29th May Coronavirus May Be a Blood Vessel Disease, Which Explains Everything and more recently the Bradykinin hypothesis:

Earlier this summer, the Summit supercomputer at Oak Ridge National Lab in Tennessee set about crunching data on more than 40,000 genes from 17,000 genetic samples in an effort to better understand Covid-19.
...
The computer had revealed a new theory about how Covid-19 impacts the body: the bradykinin hypothesis. The hypothesis provides a model that explains many aspects of Covid-19, including some of its most bizarre symptoms. It also suggests 10-plus potential treatments, many of which are already FDA approved. Jacobson’s group published their results in a paper in the journal eLife in early July.