Coronavirus Causes Damaging Blood Clots from Brain to Toes

https://www.bloomberg.com/news/articles/2020-05-04/coronavirus-causes-blood-clots-harming-organs-from-brain-to-toes

by samizdis • 6 years ago

217 107 6 years ago

shawnz• 6 years ago

An interesting explanation as to why it might have these effects, from MedCram on YouTube: https://youtu.be/Aj2vB_VITXQ

jansan2• 6 years ago

The video is interesting, but to the claim that "once it (the virus) gets inside the body, that's where it causes its greatest damage" (at 2:54 into the video) he should have added "in some cases".

ashtonkem5• 6 years ago

Once someone gets mauled by a pack of roaming coronaviruses, give me a call. Until then, I think we can agree that coronavirus is more dangerous inside the body than outside.

djsumdog• 6 years ago

Hasn't this been known for a while? I recall stroke was always a risk and one of the ways people could die from COVID-19 (including ARDS and Pneumonia)

meddlepal• 6 years ago

Speculated maybe, but known? Not widely and it looks like it's now starting to get wider attention which is a good thing. The more we know about this virus the better it will be for treatment. If clotting is a significant problem we definitely have drugs to help with that.

roenxi• 6 years ago

Before the evidence is overwhelming it is highly likely; before that probable; priorly possible and previously hinted at.

So if the coronavirus is doing something in the blood then there probably was evidence of it from the start but it is still newsworthy if the evidence has passed a new threshold.

It would make for some interesting implications if coronavirus detected in the respiratory system isn't the mechanism for bad cases of COVID-19. Some of the drug trials done looking at viral loads would be partially invalidated.

LatteLazy• 6 years ago

These articles are not helpful and should be discouraged.

jpxw• 6 years ago

Why?

eiji2• 6 years ago

Without any meaningful context into which statements and observations like this are woven into, it's mostly counterproductive for the general public.

How about we treat side effects of alcohol drinking with the same urgency and publicity? We don't. I'm sure there is a lot happening in your body when you drink 4 beers. And you could write thousands of articles just like this right now with credible studies behind them about flying, drinking, sky diving, coffee, etc. And you could make them sound even more scary. None of which is taken seriously, because in the public there is no demand for it. Because those risks are just taken as a given for existing and participating.

But at the moment every little effect is being treated like world news. Casual medications advertised for on TV have more significant side effects.

api• 6 years ago

How is reputable information not helpful?

mns• 6 years ago

well, it's Bloomberg citing one person only, it's not a scientific paper. I do find it quite worrying that when news gets hold of all kind of edge cases or special cases, with barely any scientific data to back it up (from COVID causes X, Y and Z) everyone has no issue with the scarce facts. When an actual antibody test or special cases (like the one from France with more scientific explanations and detailing how a guy who was swabbed in December got a positive result), we need to be careful as the science is not valid or there are serious doubts over minor statistical error.

_bxg13• 6 years ago

If I may, I think the GP feels that this information is stress-inducing but not really actionable for those of us not in the medical field. I don't know if I agree with their stance that it shouldn't be shared, but I sympathize.

vixen99• 6 years ago

So where will you stop? I think I'm capable of deciding that for myself without what amounts to censorship by unknown people acting on my behalf. And even if I'm not, why should my judgmental insufficiency be a watermark defining what others read?

aga98mtl• 6 years ago

I agree that they (article about rare effects) are not helpful in the mainstream media. However Hackernews is not mainstream media. Everyone here understands stats enough to put context around articles like these.

amelius2• 6 years ago

https://news.ycombinator.com/item?id=23023490

jswizzy• 6 years ago

Aren't those side effects of being hooked up to a ventilator?

mfer• 6 years ago

No. People are getting blood clots and even having strokes from them without ever being connected to a ventilator. The blood clots can happen with no or only mild symptoms.

https://www.cnn.com/2020/04/22/health/strokes-coronavirus-yo...

synaesthesisx2• 6 years ago

So this is extremely interesting, because recently several studies have shown an association between low Vitamin D levels and severe COVID-19 outcomes. This is particularly relevant, because Vitamin D appears to play a role in clotting factors as well; low Vitamin D levels have been independently associated with an increased risk of clotting events and death. There are studies investigating whether Vitamin D deficiency can cause increased thrombin generation and a hypercoagulable state.

"Of 49 patients with mild symptoms of Covid-19 in three hospitals in southern Asian countries, only two had low levels of vitamin D; of 104 patients with critical or severe symptoms, only four did not have low levels of vitamin D." https://www.telegraph.co.uk/news/2020/05/03/time-take-seriou...

"The VDI (Vitamin D Insufficiency) prevalence in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ICU patients less than 75 years old had VDI. Coagulopathy was present in 62.5% of ICU COVID-19 patients, and 92.3% were lymphocytopenic. Conclusions: VDI is highly prevalent in severe COVID-19 patients" https://www.medrxiv.org/content/10.1101/2020.04.24.20075838v...

"Vitamin D has been shown to have an anticoagulant effect. A decrease in 25-hydroxyvitamin D [25(OH)D] concentration has also been associated with an increased risk of venous thromboembolism. " https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069050/

There is also other literature suggesting that Vitamin D can reduce the risk for the "cytokine storm" which leads to acute respiratory distress syndrome by reducing the production of pro-inflammatory cytokines (while increasing the expression of anti-inflammatory cytokines). Again, I'm not a doctor but supplementation is likely to be fairly low risk. There is increasing evidence that there's some sort of correlation and it may be worth exploring.

JulianMorrison3• 6 years ago

takes 4000iu vitamin D pill What me, easily marketed to?

I wonder if any of the results show supplements work as well as diet/sunlight?

synaesthesisx2• 6 years ago

For many people diet/sunlight is insufficient - there's a host of cofactors and things that probably play a role in this. I'm not too sure on just how effective supplements are but I've personally used them to raise my serum D levels with success.

ashtonkem5• 6 years ago

They can be, but the oral absorption pathways are complicated. You need to be sufficient in other vitamins, I can’t remember which, in order to absorb vitamin D from your food.

Generally it’s recommended that sun > supplements, for a few reasons. But if you can’t get some sunlight supplements are not a bad choice at all.

pmoriarty• 6 years ago

You might want to take Vitamin K along with your Vitamin D, particularly if you're taking large doses of the latter, which can cause calcification of the soft tissues in your body, while Vitamin K makes sure that calcium gets deposited in your bones, as it should. Here is one of many articles that talks about the connection:

https://www.healthline.com/nutrition/vitamin-d-and-vitamin-k

raverbashing• 6 years ago

I believe Vit K deficiency is less common than Vit D deficiency

BruceEel• 6 years ago

Yep. K2 MK7 specifically. Cheese (most) and natto are good dietary sources of K2. The better D3 supps are formulated with an optimal D3 to K2 ratio.

amelius2• 6 years ago

There's also a connection with magnesium.

https://www.livescience.com/61866-magnesium-vitamin-d.html

silverdrake11• 6 years ago

Vitamin K also increases risk of blood clots. https://health.clevelandclinic.org/vitamin-k-can-dangerous-t...

youareostriches• 6 years ago

vitamin K deficiency is also associated with covid19 symptoms.

https://www.preprints.org/manuscript/202004.0457/v1

DanBC• 6 years ago

because recently several studies have shown an association between low Vitamin D levels and severe COVID-19 outcomes

Closer research shows it probably isn't relevant.

https://www.cebm.net/covid-19/vitamin-d-a-rapid-review-of-th...

gizmo686• 6 years ago

How do you get to that conclusion from that paper?

All I see from that paper is that there is "no evidence" that Vitamin D is beneficial with COVID-19 (and some qualified evidence that it may help other respiratory infections).

They mentions several planned/registered studies on the question, but none that have reported results yet.

JibJabDab• 6 years ago

I'm glad someone has looked into but it doesn't confirm or deny much. They were -measuring mortality- against those already infected and those "instituionalized but asymptomatic". It doesn't seem to say anything about making symptoms milder for those that contracted covid-19 after taking supplements or for those who have already contracted, which is what I think OP was suggesting.

kitotik• 6 years ago

That’s calling out a lack of formal trials providing evidence, not discrediting the data that is emerging.

Either way, they still recommend supplementing if deficient(which the numbers for people with IVD are quite high in most regions).

neffy• 6 years ago

This is interesting, because although circumstantial, what's happened here in Iceland, is that we have had markedly better outcomes than other countries. If you're interested:

http://covid.is

It would be correct to think that at 66 degrees north, and a lot of cloud cover, there is significant risk for Vitamin D deficiency. The consequence is near religious attention to taking fish oil supplements. Doctors routinely screen, Vitamin D tablets are prominently on sale in all the supermarkets etc. It's definitely a data point.

behnamoh• 6 years ago

Yes but the population of Island (364K) is way less than many other countries, so it's much easier to control the disease.

To put things in perspective, the US population is 328M.

koheripbal2• 6 years ago

Iceland is also far less densely populated

tpnCC• 6 years ago

In India,one of the slogans of Lockdown is Stay Home,Stay Safe. I think many other countries have urged their citizens to stay at home aswell.

My concern is, if the risk of transmission is more indoors than outdoors as this study indicates(https://theprint.in/health/sharing-indoor-space-major-infect...), Is staying at home making people Vit-D deficient coz of less exposure to sunlight?

And If this is true, is it one of the factors responsible for severe Covid19 outcomes?

Is this also the reason why old folks are severely affected from Covid19, coz they may tend to stay indoors more, relative to other age groups?

ceejayoz• 6 years ago

"Stay home, stay safe" only works if the other people in your home stay home too. It's not surprising people get infected indoors - one sick person in a household, office building, or restaurant will infect those nearby. You're far less likely to get it from a random passerby on the sidewalk, as your exposure time is much more limited.

acd• 6 years ago

Does Nitric oxide make the blod clot less?

casefields• 6 years ago

"Weller’s doubts began around 2010, when he was researching nitric oxide, a molecule produced in the body that dilates blood vessels and lowers blood pressure. He discovered a previously unknown biological pathway by which the skin uses sunlight to make nitric oxide."

https://www.outsideonline.com/2380751/sunscreen-sun-exposure...

ergl• 6 years ago

I thought this was going to be a roundabout article about the effects of being on my chair all day during lockdown.

stronglikedan• 6 years ago

Perhaps it is, tangentially, if you don't get any sun from your chair, and the vitamin D link turns out to be true.

101404• 6 years ago

I bought a (cheapish) height adjustable desk. Would recommend. Stand up occasionally and walk on the spot or dance or something. Especially good during online meetings :D

cs702• 6 years ago

This story in today's Washington Post seems relevant too:

"15 children in New York City have developed a puzzling and serious inflammatory syndrome possibly linked to covid-19

- The condition is similar to what doctors have observed in Europe"

https://www.washingtonpost.com/health/2020/05/05/coronavirus...

ThrowItAway2Day• 6 years ago

I remember how shocked I was when I first read about the increase in strokes associated with covid-19. Every time I read a new development about what the virus can do, I'm just dumbfounded. Either the virus is mutating, it has multiple drastically strands, or there is so much we still don't know about it. Either way, it makes me very hesitant about going out even if things are opened up.

JKCalhoun• 6 years ago

My (armchair) assumption is that we are still learning.

I'm reminded of the film, "The Andromeda Strain" (1971) — such an intelligent movie. Still feels cogent almost 50 years later.

epmaybe• 6 years ago

I'm confused about why everyone is surprised that something that elicits an inflammatory response in the body can increase your risk of blood clots. Increased inflammation -> increased clotting in a number of diseases, not limited to coronavirus. A quick literature search reveals that this is the case for a other viruses and autoimmune diseases.

This was a particularly enlightening paragraph from StatPearls: There is an interplay between inflammation and the coagulation system. Inflammation triggers a hypercoagulable state.[45] Endotoxin activates the complement system leading to thrombocytopenia and hypercoagulability.[46] The relation between inflammation and coagulation can be observed clinically in patients with purpura, vasculitis, and septic thromboembolism.[47][48] Coagulation helps to limit the expansion of infection, and some bacteria use fibrinolytic properties to oppose this response. Autoimmune diseases like systemic lupus erythematosus, immune thrombocytopenic purpura, polyarteritis nodosa, polymyositis, dermatomyositis, inflammatory bowel disease, and Behcet's syndrome increase the risk of thrombotic events.[49][50][51] The cytomegaly virus (CMV) has correlations to atherogenesis through a change of the cellular lipid metabolism and leukocyte adherence.[52]

https://www.ncbi.nlm.nih.gov/books/NBK538251/

FuckButtons• 6 years ago

According to the literature I have read, there is no evidence that Its mutating rapidly, nor is there multiple distinct strands. The increase in strokes is real, but your risk if you are <60 years old of having one is still vanishingly small. We don’t know much about the virus, nor will we for a while. Knowing things is hard, science takes a long time. We still don’t fully understand many of the pathogens that have been around for all of our collective lifetimes, so you shouldn’t expect us to be able to fully characterize one that just showed up a few months ago. What we do know from places which have been hit very hard, like bergamot is that if you are less than 60 your chance of dying from the virus is about the same as that of your risk for dying in a year, which if you are young and don’t have co morbidities is a very small number.

gshdg2• 6 years ago

There seems to be a through-line that the whole thing is related to clotting and coagulation. That basically it's not destroying lung tissue so much as preventing the blood from properly absorbing oxygen from the lungs.

_bxg13• 6 years ago

I don't think it's mutating. I think it's just very novel, and also came with its own red herring in the form of the respiratory symptoms. Doctors treated the problem in front of them and assumed it was like other things they'd seen, when in reality that was just the tip of the iceberg. But it's reassuring to me to see discoveries being made and treatment evolving. I think the disease will become much less deadly long before we have a vaccine, just due to new discoveries in how to treat it.

Jerry2• 6 years ago

This condition was observed in the UK and had similar symptoms as Kawaskai Disease:

The cases have in common overlapping features of toxic shock syndrome and atypical Kawasaki Disease with blood parameters consistent with severe COVID-19 in children.

https://www.hsj.co.uk/acute-care/exclusive-national-alert-as...

Quite alarming. Not even all kids' immune systems can deal with SARS-CoV-2.

guenthert• 6 years ago

15! There are some 2 million kids in New York. Surely you'll find more gruesome fates among some of them.

stared• 6 years ago

See D-dimer concentration in surviving and non-surviving patients: https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachme... It sky-rockets in non-surviving patients. For the context, D-dimer is a fibrin degradation product, a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.

(Fig. 2 Temporal changes in laboratory markers from illness onset in patients hospitalised with COVID-19 from "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study" https://www.thelancet.com/journals/lancet/article/PIIS0140-6...)

growlist• 6 years ago

Time to buy shares in makers of novel anticoagulants.

pvaldes• 6 years ago

Does not explain why Spain and Italy that are Mediterranean countries with lots of sun were hit hard, but Norway was spared, for example.

rrrrrrrrrrrryan• 6 years ago

Interestingly, Norwegians are tremendously cognizant about keeping their vitamin D levels up:

https://life.spectator.co.uk/articles/on-vitamin-d-sun-starv...

I think another contributing factor is cultural: southern Europeans touch, kiss, and hug each other more than northern Europeans, and may tend to sit and stand a little closer, etc.

taxicabjesus• 6 years ago

Northern Italy is a valley that tends to have very high levels of nitrogen dioxide and other air pollutants [0]. Similarly, Wuhan China has poor air quality, incinerates most its garbage, and recently vaporized a whole lot of pigs (+/- 1million?) due to swine flu.

[0] http://www.esa.int/ESA_Multimedia/Videos/2020/03/Coronavirus...

Joof• 6 years ago

It's supposed to look like HAPE -- blood clots are actually coming in and blocking blood vessels in the lungs.

Coronavirus Causes Damaging Blood Clots from Brain to Toes

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