By Robert Preidt
The report offers new insight into how the damage of inflammation caused by COVID-19 can linger and how best to treat recurring clots, the Rutgers University researchers said.
There have been reports of lower extremity blood clots in patients after COVID-19, but this is the first known case in which COVID-19 triggered a blood clot recurrence in the upper arm.
The patient was an active 85-year-old man who had a prior diagnosis of upper extremity blood clots, according to the study published online recently in the journal Viruses.
"The patient presented to his primary care physician with complaints of swelling in his left arm and was sent to the hospital for further management where he was diagnosed with an upper arm blood clot and an asymptomatic COVID-19 infection," said study co-leader Payal Parikh, an assistant professor of medicine at Rutgers Robert Wood Johnson Medical School, in New Jersey.
"While his oxygen levels were not diminished, he was hospitalized for the management of the upper extremity deep vein blood clot. Often, blood clots are preceded by chronic inflammatory conditions exacerbated by immobility, and rarely do they occur in patients who are otherwise healthy and active at baseline," Parikh noted in a Rutgers news release.
Most deep vein blood clots occur in the legs. Only about 10% of blood clots occur in the arms, and of those cases only 9% recur, the study authors noted.
"This is of concern since in 30% of these patients, the blood clot can travel to the lung and be possibly fatal," Parikh said. "Other disabling complications include persistent swelling, pain and arm fatigue."
This case study shows that health care providers should consider testing for deep vein thrombosis and COVID-19 in patients who have unexplained swelling, and that people who test positive for COVID-19 should seek medical attention if they have declining oxygen levels, shortness of breath and any unexplained swelling, Parikh advised.
"If you have been previously diagnosed with deep vein thrombosis or have chronic medical illness that predisposes you to blood clots, you have a higher risk for recurrence of a deep vein thrombus in the setting of a COVID-19 infection and thus, should be vigilant," Parikh said.
The American Society of Hematology has more on blood clots.
SOURCE: Rutgers University, news release, May 15, 2021