As coronavirus spread through New York City in late March, doctors at Mount Sinai Hospital noticed something strange happening to patients’ blood. Signs of blood thickening and clotting were being detected in different organs by doctors from different specialties. Nephrologists noticed kidney dialysis catheters getting plugged with clots. Pulmonologists monitoring Covid-19 patients on mechanical ventilators could see portions of lungs were oddly bloodless.
Neurosurgeons confronted a surge in their usual caseload of strokes due to blood clots, the age of victims skewing younger. “It’s very striking how much this disease causes clots to form,” Dr J Mocco, a Mount Sinai neurosurgeon, said, describing how some doctors think Covid-19 is more than a lung disease.
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In the three weeks beginning mid-March, Mocco saw 32 stroke patients with large blood blockages in the brain, double the usual number for that period. Five were unusually young, under age 49, with no obvious risk factors for strokes. The youngest was only 31. At least half of the 32 patients would test positive.
Patients now receive high doses of a blood-thinning drug even before any evidence of clotting appears. “Maybe, just maybe, if you prevent the clotting, you can make the disease less severe,” said Dr David Reich, the hospital president. The new protocol will not be used on certain high-risk patients because thinners can lead to bleeding in brain and other organs.