A 55-year-old woman is dying.
In the process of understanding the mechanism by which nCoV kills patients, doctors discovered that small blood clots were the cause of fatal lung congestion.
However, Dr. Poor could not prove this.
`I told my colleagues, ‘We don’t have anything to lose’. At that point, I decided to not only administer anticoagulants but also drugs that break up blood clots,` Dr. Poor recalls.
The patient wasn’t able to get enough oxygen even after doctors turned her over to perform prone ventilation, a technique that increases air to the dorsal lung area.
Twenty minutes after injecting tPA (tissue plasminogen activator), which helps break up blood clots, this patient’s oxygen levels increased.
`She got better, but then it started getting worse. We most likely broke the clot, but another clot immediately formed,` Poor said.
Dr. Hooman Poor, (right) and colleagues at Mount Sinai Hospital in New York.
However, the above measure only prolonged this patient’s life for a few more days.
Last weekend, Dr. Poor’s team tested the anticoagulant method on four other critically ill patients.
In a new report, Dr. Poor calls for more urgent research into whether abnormal blood clots are putting patients at risk or not.
What has happened to blood clots in Covid-19 patients remains a mystery.
Many hospitals are trying to use anticoagulants to prevent blood clots from forming.
This is an example of how difficult it is for doctors to fight Covid-19 when they have to figure out what treatment methods to use in the absence of a vaccine or official treatment regimen.
Others are also doing research on this issue.
`We are treating extremely critical patients, they are dying in front of us. We cannot have any diagnostic tests. Still, treatment decisions have to be made.`, Tien
Mr. Pugliese commented on Poor’s report: `What these doctors did with these critically ill, dying patients was a decision based on instinct and it was the right thing to do.`
But given the risk of bleeding, choosing patients for testing must be careful, Pugliese said.
Dr. Poor often treats patients with pulmonary embolism, a large blood clot in the lungs that can kill the patient very quickly.
Poor recalls a rare disease in which some pulmonary blood vessels dilate abnormally even while others are clogged.
`I tested on five cases. Nothing has been proven yet, but at least it sets the stage for further studies, helping to show exactly what is going on,` said Dr. Poor.