There is increasing evidence of the association between Covid-19 and arterial thrombotic events as many post-Covid patients have suffered from limb and life-threatening blood clots in the arteries of the legs, doctors say. Dr Rahul Sheth, interventional radiologist, Zen Multispeciality Hospital, said, “24 patients have been treated for lower limb arterial clots. We have been able to save 17 limbs, where no amputation was required. Seven patients required some form of amputation since they presented late. Out of the 24 patients, two presented in the first wave, and 22 in the second wave,” said Dr Sheth.
Various studies have stated that covid infection leads to clots in the arteries that are responsible for carrying oxygen-rich blood to the body from the heart, and this can be termed arterial thrombosis, explained Dr Sheth.
“It is postulated that Covid-19 increases the blood’s viscosity which can lead to clots. When the blood flow in the artery is blocked due to clots, there is no oxygen supply to the body parts. When this affects the legs, it can lead to severe leg pain, cold limbs and if untreated will progress to gangrene with amputation or removal of the limb to save the patient’s life. These blood clots can also travel all over the body and damage distant organs,” Dr Sheth said.
Dr Bipin Jibhkate, consultant critical care medicine, and ICU director Wockhardt Hospital, Mira Road warned against delaying treatment. “If you notice symptoms such as swelling and leg pain, chest pain, numbness, and weakness in the body, do not delay treatment. To prevent arterial thrombosis, one needs to adopt a healthy lifestyle. Try to reduce the intake of sodium in the diet, avoid smoking as it can be injurious to health, and try to keep moving as much as you can. It is essential to exercise every day, and this can keep blood clots at bay. So, bid goodbye to sedentary lifestyle right away, and stay fit,” said Dr Jibhkate.
The golden period to treat is within 24 hours after the onset of the symptoms. “Any symptoms like leg pain, pain in walking, cold limbs should not be ignored and a doctor should be consulted. Examination of the affected leg and palpation of the foot pulses should be done. If the pulses are absent, then immediate admission should be done, followed by an arterial colour doppler,” said Dr Sheth.
Colour doppler is like sonography for the blood vessels to detect blockage. “Then, a peripheral angiography is performed to confirm the diagnosis and decide on a treatment plan. Two main options are considered; endovascular, where the clots are removed using a special catheter and a clot-busting drug is given to dissolve the clots; or surgical wherein an incision is made in the artery and the clot is removed using a device. Endovascular is preferred nowadays since the clots in the small blood vessels in the leg and foot can also be cleared,” explained Dr Sheth.
Timely follow-up, early detection of symptoms, and prompt treatment will prevent complications and limbs can be saved from gangrene setting in and amputation.
“There is no awareness regarding this condition and the patients ignore the early symptoms. Some come to the hospital in advanced stages with discolouration of skin or gangrene. The first 12 to 24 hours are crucial as blood circulation needs to be restored. Don’t take severe leg pain or any abnormal changes in the body casually, especially during the post-covid period,” said Dr Sheth.