Coronavirus and blood clots: Causes, effects and treatment

The effects of Covid-19 on people are varied but city doctors have observed that there is a possibility of heart attacks, especially in youngsters.

Some city experts say heart attacks after Covid-19 are caused due to the presence of blood clots in the body. However, others believe there is neither any scientific evidence to prove blood clot-related heart attacks occur due to Covid-19 nor that the virus causes disproportionally more heart attacks than otherwise. The jury is still out but the fact that heart attacks and blood clots and their presence in people who have suffered from Covid-19 is being discussed cannot be ignored.

Mid-day Online spoke to Dr Manish Hinduja, consultant-cardio thoracic and vascular surgery, Fortis Hospital and Dr Pravin Kahale, consultant, cardiology, Kokilaben Dhirubhai Ambani Hospital to understand more about the causes of blood clots and the effects post-Covid. They also shed light on the symptoms one must be aware of and the preventive measures but while taking expert advice.

What causes blood clots in people after they suffer from Covid-19?
Hinduja: In Covid, clots form in blood vessels because once the virus binds to ACE 2 receptors on blood vessel lining cells, it activates the release of clot-forming proteins. It is also sometimes due to hyperactive inflammation caused by the virus in the body.

Kahale: Any infection which damages the wall of the blood vessels increases the chances of clotting in the body and that is not particularly due to Covid, many infections can also lead to blood clots.

Do blood clots cause heart attacks in people who have suffered from Covid-19? What are the other complications that could occur due to these clots besides heart attacks?
Hinduja: Yes, clots if formed in blood vessels of the heart, can lead to heart attack. Clots can also cause stroke, pulmonary embolism, deep vein thrombosis in legs or arms, and kidney but rarely liver damage.

Kahale: Blood clots can occur due to multiple infections. There is no evidence of blood clot-related heart attacks due to Covid-19. Apart from leg veins called deep vein thrombosis, other complications that can occur are paralysis due to clots in the brain, and lung arteries.

Has there been an increase in the number of heart attacks due to blood clots or people coming with clots after suffering from Covid-19?
Hinduja: Definitely. There is an increase in the number of heart attacks after Covid infection (especially in the younger age group).

Kahale: There is no evidence that Covid causes disproportionally more heart attacks.

What are the chances of the blood clots occurring? Do they appear more in any particular age group?
Hinduja: About 20-30 per cent of patients with Covid-19 infection needing ICU treatment, show features of blood clot formation within six months of infection. Although it is more common in elderly hospitalised patients, it is also seen in young patients who have no comorbidities.

Kahale: Blood clots in mild to moderate Covid cases are uncommon. In case of severe Covid, the chances of blood clots occurring are still less. There is no particular age which is more susceptible.

Which part of the body do the blood clots occur the most?
While Hinduja says blood clots occur in the lungs, heart and brain vessels, Kahale adds that they mostly occur in leg veins and lung circulation.

Can people avoid getting blood clots after Covid-19?
Hinduja: Yes, preventive treatment with blood thinners and early diagnosis is the key.

Kahale: A patient who has suffered from severe Covid-19 infection can take a blood thinner based on the need, and guidance of a doctor.

Are there any foods people can eat to prevent getting blood clots eventually causing heart attacks? Do they need to make lifestyle changes?
Hinduja: Staying active, avoiding smoking and reducing weight for obese patients can help in reducing the risk. Common foods like ginger, turmeric and garlic have been shown to have some blood thinning effects. However, their role in preventing Covid 19-related blood clots, is not well-documented.

Kahale: In terms of blood clotting due to Covid-19, there are no specific food or lifestyle changes required. The risk of developing blood clots for a patient suffering from severe Covid-19 is only a potential threat until a patient is Covid positive.

What are the signs or symptoms for people to realise they have a blood clot? Why should they be concerned?
Hinduja: There is sudden chest pain, swelling in arms or legs, drowsiness and weakness in limbs.

Kahale: Blood clots depend upon the area where the patient is affected. If it occurs in the lungs, it can cause breathlessness. If it is in the legs, then it can cause swelling of the legs; heart blood clots lead to a heart attack-like chest pain, and clots in the brain can cause paralysis or stroke.

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(Disclaimer: This article is not intended as a substitute for professional medical advice, diagnosis or treatment. Mid-day Online does not in any way endorse the accuracy, completeness, efficacy or timeliness of any advice or line of treatment mentioned in this article. Readers must always seek the advice of a certified medical practitioner and/or a mental health professional before deciding on or starting any course of treatment.)