Covid-19 and clots - alarming new findings

15/4/2020

Our Zoom for Thought series was kicked off by Prof. Fionnuala Ní Áinle, Co-Director, UCD Conway SPHERE and Clinical Lead in the Department of Haematology at Dublin's Mater Misericordiae hospital. She spoke to our host, UCD Discovery Director Prof. Patricia Maguire about interdisciplinary research in a global pandemic and the alarming prevalence of blood clots in critical Covid-19 cases.

Fionnuala Ní Áinle presented her recent Zoom for Thought talk dressed in scrubs, live from the Mater. Ní Áinle specialises in venous thromboembolism - or blood clots - which usually develop in the legs or lungs.

“As you can imagine the hospital is a busy place at the moment,” she said on April 14th, when Ireland had some 11,500 positive Covid-19 cases. 

“And what we are realising is that patients affected with Covid-19 have evidence of blood clotting activation, which may predict disease severity,” she explained. “We are now gathering data as an international community on what the incidence of thrombosis is in critical care patients affected by Covid-19. Early signals from recently published studies suggest rates of venous thromboembolism of up to one quarter of patients affected with Covid-19 in critical care.”  

These are deeply concerning numbers; pre-Covid-19, blood clots were already one of the leading causes of preventable hospital deaths. 

“That for me highlights the great importance of never missing an opportunity for venous thromboembolism [VTE] risk assessment at the points when a patient with Covid-19 enters a hospital,” she said. "This further highlights the need to prevent blood clots when we can in our hospitalised patients. Ongoing studies aim to give us more data on the prevalence of venous thromboembolism in all patients infected with Covid-19 and how best to prevent them. What we can do in the meantime is to follow the excellent advice of the HSE and the patient organization Thrombosis Ireland, and give every patient a VTE alert card before they go home from hospital, including those affected with Covid-19​.”

Ní Áinle told Zoom for Thought attendees that Covid-19 patients fortunate enough to recover in hospital still remain at increased risk of getting a clot for up to 90 days after discharge. 

“It’s so important that we as the medical community educate our patients and colleagues and their families so that we never miss an opportunity to save a life due to thrombosis in the post-discharge period,” she emphasised. “And now is the time to really remember this risk and never miss an opportunity to share that awareness so cases are not missed.”

The symptoms of deep vein thrombosis are lower limb pain or swelling, and pulmonary embolism - coughing up blood or shortness of breath. 

“These are also symptoms that can overlap with Covid-19,” noted Prof. Ní Áinle. “So it is very important for us to work together as an interdisciplinary team of clinicians and scientists to take every opportunity to learn about this condition - we’re learning very fast - and to use these learnings in a way that advances our knowledge and advances hypothesis generation so that we can make a difference to outcomes.” 

This article was brought to you by the UCD Institute for Discovery - fuelling interdisciplinary research collaborations in UCD.