RAISED blood levels of D-dimer have been strongly associated with poor prognosis of coronavirus causing experts to investigate and provide guidance on treatment of blood clots in patients who have tested positive for coronavirus.
Radiologists and vascular specialists were enlisted to collect information on imaging examinations, symptoms, diagnosis, prevention, and treatment options for thrombotic complications in patients with COVID-19. The imaging data collected indicated that symptoms experienced by these patients are not solely attributed to pulmonary complications and observations suggest that microvascular thrombotic processes impact respiratory failure in COVID-19. Chest CT scan results, D-dimer levels, and progression of disease are all strongly associated and suggest venous thrombosis.
The authors of the report highlighted the importance of diagnostic and treatment actions in the increased number of patients with COVID-19 and potential prothrombotic and thrombotic conditions; management for which includes prophylactic-dose heparin, chest CT, CT pulmonary angiography, and regular D-dimer testing. “Imaging and pathological investigations confirmed the COVID-19 syndrome is a thromboinflammatory process that initially affects lung perfusion, but consecutively affects all organs of the body,” explained Prof Edwin J.R. van Beek, director at Edinburgh Imaging, Queens Medical Research Institute, at the University of Edinburgh, Edinburgh, UK.
Further research carried out in France using pulmonary CT angiograms has shown an increase in acute pulmonary embolus in 30% of patients from the centre with COVID-19, compared to the expected rate of 1.3% of pulmonary embolus in patients who are critically ill but do not have the disease. Further case-reports from medical care centres have detailed the use of contrast CT scans showing high numbers of patients with COVID-19 and pulmonary embolus, linking COVID-19 with pulmonary embolism, specifically. “COVID-19 is more than a lung infection,” Prof van Beek stated. “It affects the vasculature of the lungs and other organs and has a high thrombosis risk with acute life-threatening events that require adequate treatment with anticoagulants based on laboratory monitoring with appropriate imaging tests as required.”