Hyderabad: After noticing unusual blood clotting in many patients diagnosed with COVID-19, doctors at Emory University (Hospital & Education), USA believe there may be a connection to the thickness of their blood, known as hyperviscosity, with inflammation and clotting.
“It has been a mystery why so many patients with COVID-19 have had atypical blood clots. We realized we needed to think beyond our typical testing strategies to understand why this might be happening,” says Cheryl Maier, MD, PhD, assistant professor of coagulation and transfusion medicine.
The clinicians tested plasma viscosity (thickness of blood plasma) in 15 critically ill COVID-19 patients with pneumonia who were admitted to Emory Healthcare intensive care units (ICUs). All of them had plasma viscosity levels above the normal range. The sickest patients had the highest plasma viscosity levels, more than double normal levels, and were also more likely to have a blood clot.
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“Despite prescribing medications to prevent blood clots to COVID-19 patients, clotting still occurred, which is quite unusual,” says Maier, “One thing that stood out was the extremely high levels of fibrinogen, a big sticky protein that increases with inflammation and is a key building block for making blood clots.” Maier realized that fibrinogen can also increase plasma viscosity, so the team turned to viscosity testing, which uses an old-fashioned laboratory test with glass tubes to help determine blood thickness.
The team is actively exploring alternative treatment options based on this new finding, including the use of therapeutic plasma exchange, which thins the blood and is a standard treatment for other conditions associated with hyperviscosity.
