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COVID-19 shown to increase risk of blood clots

Not long after being diagnosed with COVID-19, Jordan Hoey was referred to the Thrombosis Clinic at St. Paul's Hospital.

When Jordan Hoey learned that his partner, a healthcare professional, had been exposed to COVID-19 in the workplace, he knew he would be at risk of contracting the virus. However, he had no idea it would ultimately lead to multiple pulmonary embolisms – blood clots in both his lungs.

According to the World Thrombosis Day website, blood clots are a known complication among COVID-19 patients and can contribute to other life-threatening medical conditions. With this top of mind, the St. Paul’s Hospital’s Thrombosis Clinic sees more need now than ever to present a free Zoom event this Thursday, Nov. 26 to educate the public about symptoms and risk factors.

Hoey, 29, is a CPC engineering technologist with BC Hydro who has always been fit and healthy. But after hearing about his partner’s exposure last May, he promptly got tested and was diagnosed with COVID-19. Initially, Hoey’s symptoms were heavy fatigue and a general achiness. A fever that lasted 10 days soon followed and was accompanied by muscle aches, headaches and ongoing fatigue.

The search for clots

About two weeks after his diagnosis, he started coughing up blood. At St. Paul’s Hospital’s ER, he was referred to the Thrombosis Clinic. There, he found out he had multiple pulmonary embolisms. Even though he had no underlying health issues, he was prone to clots because COVID-19 creates a prothrombotic state in patients – an abnormality of blood coagulation that increases the risk of blood clots.

“As my fever began to subside, I thought I was in the clear. Blood clots were the last thing on my mind,” said Hoey. “Little did I know what the next few months would bring.”

At the clinic, he was given blood thinners but suffered bad chest pain for several months afterwards. It’s not known whether or not the pain resulted from the clots or COVID-19 itself.

These days, he is feeling better but still experiences severe midday fatigue. He recently returned to the worksite after being off work and at home since the summer. He continues to have chest pain on exertion and/or during exercise, and has arthritis in his wrists due to the virus. As a result of his ordeal, he is keen to spread the word about the risk of blood clots in COVID-19 patients.

COVID-19 patients and blood clots

Dr. Anna Rahmani, who is a co-director of the Thrombosis Clinic along with Dr. Tony Wan, says that blood clots don’t discriminate, especially during a pandemic. She confirms that there’s been a definite increase in the number of COVID-19 patients with blood clots, especially in those who are admitted to hospital, which is a known risk factor. However, the clinic has also seen COVID-19 patients with blood clots who haven’t been admitted to hospital.

Dr. Rahmani

She says the clinic relies on the typical signs and symptoms of blood clots in order to investigate the possibility of them. These include shortness of breath, chest pain that feels like stabbing pain, heart palpitations, fainting or pre-fainting spells, and leg swelling, pain or redness.

“With COVID-19 patients, we pay extra attention to their respiratory systems and assess if they are experiencing worsening symptoms, such as increased oxygen requirement or increased breathing difficulty,” said Rahmani. “We then look very quickly for blood clots in the lungs (pulmonary embolism) by doing a CT scan, and we ultrasound for possible clots in the legs when COVID-19 patients present with pain, redness, swelling or calf ache.”

Based on observation and anecdotal evidence, she believes doctors have been more vigilant to investigate blood clots when patients have COVID-19.  

Clots to talk about

Given surging COVID-19 cases and the fact that one in four deaths worldwide is related to blood clots, it’s critical that people know how to look for the signs of them, even in the midst of a public health crisis. This Thursday, Nov. 26 from 6 p.m. to 7 p.m., the Thrombosis Clinic will be presenting a free public Zoom session. Space is limited to 250 participants. If you would like to participate, find out how here.

When to seek help

Rahmani says that a person can be completely healthy and develop a clot; none of us are immune. For a blood clot in the leg, the most telling symptoms are calf pain, swelling and redness. It can initially feel similar to the discomfort you have after having over-exercised or with a charley horse.

In the case of a blood clot in the lung (pulmonary embolism), the main symptoms are shortness of breath, sharp, knife-like chest pain, and cough that is sometimes associated with bloody streaks.

If you develop any of these symptoms, please seek medical attention immediately.

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