“Blood thinners don’t reliably prevent clotting in people with Covid-19, and young people are dying of strokes caused by the
ytokine storm
When people infected with Covid-19 develop the classic symptom of breathing difficulty, it’s because the coronavirus has infected the lungs and the immune system is at work.
Most patients recover. But if the infection persists, the immune system goes into overdrive, releasing a flood of inflammatory proteins, called cytokines, that contribute to cell death and lead to acute respiratory distress syndrome.
When a cytokine storm strikes, lung tissue can become irreversibly scarred, the lungs fill with fluid, and patients often die. The flood of cytokines also fuels an overload of white blood cells, one of the body’s primary protectors which, in the confusion, begins to attack healthy cells, according to a May 13 study in the journal Frontiers in Public Health. This overaction by the immune system causes hyperinflammation in tissues that can also affect other parts of the body by causing leaky blood vessels, extremely low blood pressure, and a lack of oxygen in the blood.
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Silent hypoxia and Covid pneumonia
Some people with Covid-19 develop dangerously low levels of oxygen in their blood but otherwise don’t feel terribly sick. They might complain of mild flu-like symptoms and perhaps a little shortness of breath or maybe just tiredness.
The condition has been called silent hypoxia and resembles the low oxygen levels a person suffers when breathing the thin air at high altitudes. These people are in critical condition, though they don’t realize it. (X-rays reveal their air sacs in the lungs are filled with fluid or pus.) The low oxygen levels, untreated, can quickly cascade into serious breathing problems and damage to other organs.
Scientists don’t know exactly what’s going on, but some doctors are calling the condition Covid pneumonia. Autopsies of a small number of people who died from Covid-19 find, because of all the water, lungs weighing more than four pounds, and in one case seven and a half pounds, compared to the normal average of under two pounds.
Blood clots
Only recently have doctors realized that Covid-19 seems to be infecting blood and damaging blood vessels. In one study, 31% of people in intensive care with Covid pneumonia had blood clots. These clots, which the body creates in an effort to stop bleeding, can break up and travel to the lungs or cut off blood flow to the brain, causing a stroke.
“Blood thinners don’t reliably prevent clotting in people with Covid-19, and young people are dying of strokes caused by the blockages in the brain,” science writer Cassandra Willyard notes in a review of the early research on the topic for the journal Nature.
The presence of blood clots can be indicated by levels of protein fragments from the clot, called D-dimer. Doctors are seeing unusually high D-dimer levels in many Covid-19 patients.