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'Not the typical patient': Vascular surgeon seeing COVID-19 patients with blood clots

Dr. Barbara Melendez said patients without the typical profile for arterial disease are testing positive for COVID-19 — and their only symptom is a blood clot.

AURORA, Colo. — Most people diagnosed with COVID-19 experience respiratory symptoms, but there is a small group that will also experience cardiovascular complications, according to Dr. Barbara Melendez, a vascular surgeon,.

Melendez is treating such patients at the Vascular Institute of the Rockies.

9NEWS sat down with Melendez to learn more about these patients and how they are being treated.

(Editor's note: Answers have been edited for context and clarity.)

What is the connection between COVID-19 and blood clots? 

Melendez: COVID-19 creates a very extensive inflammatory response within the body. That inflammatory response can result in different things within the cardiovascular system. The whole path of physiology hasn’t been explained yet, but it’s certain that we’re seeing a significant increase of cases related to COVID-19.

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How many cases? 

Melendez:  Internationally, 17% of cases have cardiovascular complications. 

Who are the patients you're seeing? 

Melendez: We have seen definitely cases in our office and around the state of people who presented with an arterial or venous thrombosis out of nowhere and were tested positive for COVID.

So they didn't know they had COVID-19 until they received an antibody test while being treated for a blood clot?

Melendez: They were maybe asymptomatic for the disease, and this is the only symptom that they’ve had.

And those people aren't your typical blood clot patients?

Melendez: These are people like a 34-year-old-female who has a clot  in the largest artery of her body, which makes no sense to anyone, just not the typical patient...or a gentleman who comes in with a clot in his leg who had never had any symptoms [and] had never had anything like this happen to him.

Credit: Vascular Institute of the Rockies
The ultrasound of a COVID-19 patient with a blood clot.

Is there anything else you're seeing that's different?

Melendez: We’re also seeing what’s called microembolism...the tiny arteries in your toes get tiny clots in them and the skin surface can die or your toes can start to become gangrenous from having had COVID in the past...we actually just had one in the office on Friday.

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Would you call this cardio vascular complications widespread?

Melendez: No...we are seeing all these issues, and I want to make sure people know this could be related to COVID, and they are taking care of themselves, — but it is not the majority of cases.

Melendez said symptoms like swelling in the leg, blueness of an extremity, shortness of breath, severe pain and decreased sensation could be symptoms of venous or arterial thrombosis and you should seek medical attention immediately. 

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