DANGER OF BLOOD CLOTS

Doctors recommend blood thinners for Covid-19 patients

Some Kenyans who collapsed and died suddenly had blood clots triggered by Covid-19.

In Summary
  • Most clots form in the deep veins of the leg, groin or arm and end up in the lungs where they block some or all of the blood supply.
  • Where blood clot tests are not available, patients should be managed with therapeutic doses of anticoagulant therapy.
A nurse at the Kapsabet County Referral Hospital isolation ward for Covid-19 patients
HOSPITAL A nurse at the Kapsabet County Referral Hospital isolation ward for Covid-19 patients
Image: FILE

Local doctors have recommended blood thinners for hospitalised Covid-19 patients, following increased evidence that many of them are being killed by blood clots.

Recent autopsies on some Kenyans who collapsed and died suddenly show some were sick with Covid-19 and had developed blood clots, which killed them.

Most clots form in the deep veins of the leg, groin or arm and end up in the lungs where they block some or all of the blood supply.

 
 
 
 

The patient then begins to cough, sweat and gasp for breath and collapses. 

"Emerging evidence from autopsy and imaging studies are showing that the majority of the patients suffer or die from thrombosis related complications," says the Kenya Society of Thrombosis and Haemostasis in proposed treatment guidelines submitted to the Ministry of Health last week.

Doctors David Maina (chairman of the society), Harun Otieno (vice-chair), Gordon Ogweno (secretary general) and Peter Waweru (treasurer) say the risk of blood clots is highest for hospitalised Covid-19 patients and those in isolation and quarantine because they are immobile.

The medics recommend imaging and laboratory testing for blood clots in all such patients. 

Where such tests are not available, the patients should be managed with therapeutic doses of anticoagulant therapy as per standard of care for patients without Covid-19.

"Due to high prevalence of thrombosis in Covid-19 than non-Covid-19 patients, it is recommended to start anticoagulation early to avert disease progression or prevent severe forms," they say in the proposed guidelines.

The ministry is yet to adopt the recommendations but some health facilities are already implementing them.

 
 
 
 

The preferred therapy are blood thinners called heparin which have additional anti-inflammatory and anti-viral effects.

Across the world, doctors are reporting high rates of blood clots in patients who are seriously ill with Covid-19.

A recent Dutch study of 184 patients with Covid-19 pneumonia admitted to an intensive care unit found a 49 per cent cumulative incidence of thrombotic (blood clot-related) complications.

Postmortem studies are also finding clots in the capillaries of the lungs in Covid-19 patients, restricting the oxygenated blood from moving through the lungs.

Last week, medical director at MP Shah Hospital Dr Vishal Patel told the Star that some asymptomatic Covid-19 patients in Kenya are still experiencing blood clotting disorders because the virus can still ravage blood vessels.

"For patients with severe disease, and we see they don’t have a significant bleeding risk, we normally give them blood thinners,” Dr Patel said.

On Wednesday Kenya recorded 544 new cases of Covid-19, raising the country's total to 19, 125, Health CS Mutahi Kagwe said.

The new positives were drawn from the 5,259 people whose samples were tested within 24 hours.

Edited by Henry Makori