(Lipi Roy, MD, MPH/ Forbes) — I will never forget my first night on call in the Duke cardiac care unit (CCU). A 49-year-old woman was urgently transferred from the medicine ward with severe shortness of breath, hypotension and tachycardia. It was only my second month as an intern and I was pretty nervous. But I remembered enough to know that “Ms. V.” was critically ill and needed emergent medical attention: central line, intravenous fluids, vasopressors, mechanical ventilation. With confident and caring guidance of my senior cardiology fellow who carefully reviewed the pulmonary angiogram results with me, we identified the problem. Ms. V. was having a massive pulmonary embolism (PE).
COVID-19 has been associated with clot formation. From deep venous thrombosis (DVT) in lower extremities to blocked arteries in the brain and lungs, resulting in strokes and PEs, respectively, this novel coronavirus is wreaking havoc on the body’s coagulation system. But recent evidence suggests that blood thinner medications may improve survival in patients who develop dangerous blood clots.
“COVID patients are clearly at higher risk of thrombotic events,” observes Matthew Cavender, MD, MPH, assistant professor of medicine and interventional cardiologist at University of North Carolina – Chapel Hill. Blood thinners certainly play a role in clot prevention. Adds Dr. Cavender: “There’s no question that DVT prophylaxis is needed – maybe even at slightly higher doses – and is beneficial in critical illness.” (…)