Updated: Jun 15, 2020
by Annita M. Taylor, MBA, MSN, APRN, ANP
Since Coronavirus/COVID-19 is so new and not much is known about it, there is very little understanding of how exactly the virus is causing deaths. Reports and testing have shown that people who are infected with the virus and reach a severe condition develop pneumonia, multiple organ failure, and acute respiratory distress syndrome. When blood is drawn on some patients, it has clotted in the tubes before reaching the lab. Autopsies of COVID-19 patients have revealed hundreds of micro clots throughout their lungs. Though this has helped medical professionals ascertain that clots form from the virus, they are still trying to figure out why.
Blood clotting is a natural occurrence in the body, but when blood starts clotting in blood vessels, these clots may dislodge and travel to the heart, brain, or lungs. It has become clear that COVID-19 affects the respiratory system, specifically the lungs. What is not clear is how exactly it affects the lungs and what is causing deaths. Now, new research is pointing towards pulmonary embolisms. Since blood clotting is activated in the human body as a response to a virus, it is now being considered that they might be the reason for the respiratory failures in people infected by the virus. Radiology published research showing that 23 of 100 patients with severe COVID-19 had signs of a pulmonary embolism.
Since blood clots are already becoming a concern in patients affected by COVID-19, there is a question whether putting them on the ventilator is doing more harm than good. Ventilators can cause damage to the lungs, which can lead to hypoxemia, which means there is too little oxygen in the blood. This can cause blood to coagulate and result in blood clots. There is another factor to take into account: ventilators cause patients to be immobile, and immobility is also a major cause of blood clots. Genetics and obesity may also factor into why patients are developing blood clots. Inflammatory chemicals are activated within fat tissues in the body. COVID-19 produces even more inflammatory response as a virus alters the immune system.
Unlike most diseases of a similar nature, COVID-19 patients across the board are being affected by clotting, which doctors are finding strange. This is leading them to put patients on blood thinners, whether they are being treated at home or on the ventilator during hospitalization. Although some may become well enough to be discharged home to continue recovery from COVID-19, they are still at high risk for developing blood clots in the lungs which can lead to death.
Here is how you can help prevent pulmonary embolisms at home while fighting and or recovering from COVID-19 post hospitalization:
Know the signs and symptoms of clots. Swelling, pain, or redness in the calf or lower extremities. Shortness of breath, difficulty breathing, and or chest pain. Should you experience any of these symptoms seek medical attention immediately.
Take Your Meds. If you are prescribed blood thinners, take your medication on time daily as prescribed. Speak with your medical provider about risk factors you may have and the need for anti-coagulating medication and foods to avoid while taking them.
Get Moving! Exercise as much as you can daily. If you are bedbound, make sure you perform arm and leg exercises while in bed for as little as 3-minute intervals every hour. If there is someone who can help you do this safely, ask for their help. Ask your medical provider to order a compression device such as an inflatable air compression set to improve blood circulation.
Do not cross your legs while sitting. Move and stretch your legs. Wear compression stockings when sitting or standing for long periods of time. Elevate your feet and legs above the heart level for about 30 minutes at least twice daily.
Stay hydrated. Drink fluids such as water and natural fruit juice. Avoid excessive sugary drinks, energy drinks, and caffeine.
Avoid smoking. Smoking increases your risk of developing clots. Speak with your medical provider about assistance with smoking cessation if needed.
Wear loose-fitting clothes. Tighter fitting clothes can increase blood pressure and restrict the flow of blood placing you at a higher risk of developing clots.
If you are overweight, consider weight loss. This may be easier said than done. Incorporating healthier food choices and a daily exercise routine while avoiding junk foods may help trim extra pounds. Speak with your medical provider about other causes and treatments of weight gain.
There are many factors about COVID-19 that are still largely unknown; however, as research increases, so does the hope for finding causes, cures, and vaccines. Take these steps and speak with your medical provider to help avoid the formation or progression of blood clots.
Stay safe, informed, and healthy!
NP, A.M. Taylor