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From Brief19: SARS-CoV-2 And Blood Clots

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April 9, 2020

There have been reports of SARS-CoV-2 patients with critical illness also developing abnormal blood clots. These clots often form and remain in large veins, but can become far more dangerous if they travel to the lungs or the brain. In a letter published in The New England Journal of Medicine, physicians from the Tongji Hospital in Wuhan, China describe three severely ill covid-19 patients who developed multiple infarcts (blockages of the blood to tissues that cause the tissue in the surrounding area to die from oxygen deprivation) in the brain.

Tests from the three patients showed signs that the patients’ blood was substantially prone to forming such clots. Specifically, all three patients were found to have “antiphospholipid antibodies” in their blood. These antibodies, produced by the patients’ own immune systems, can attach to proteins on the inner-lining of blood vessels and make abnormal clots more likely to form. While some individuals have an autoimmune condition called “antiphospholipid antibody syndrome” in which these antibodies are produced throughout their lives, it is also thought that patients with serious illness (including from viral infections) can temporarily make these antibodies as well.

While this has been well-described in the medical literature, it is unknown how large the increase is during infections like SARS-CoV-2. So, it remains unclear whether the patients described in this publication represent common or unusual events in covid-19 patients.

Shared with permission from Brief19, a daily review of #covid-19 research and policy.

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