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Blood clots continue to wreak havoc in patients with severe Covid-19 infection, and a new study explains what can lead to their onset in nearly half of patients.
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The new study found that “Covid-19” leads to the production of an autoimmune antibody which spreads in the blood and attacks cells and leads to clots in arteries, veins and microscopic vessels. Blood clots can cause life-threatening events such as stroke. In the case of “Covid-19”, microscopic clots can restrict blood flow in the lungs, impairing the exchange of oxygen.
Aside from a new coronavirus infection, these antibodies causing clots are usually seen in patients with antiphospholipid syndrome from an autoimmune disease. The relationship between autoantibodies and “Covid-19” was unpredictable, says study co-author Eugene Kanthe, MD, associate professor at Michigan Medicine Frankel Center for Cardiovascular Diseases, and researcher at National Heart, Lung, and Blood Institute. Affiliated with the National Institutes of Health.
“In patients with Covid-19, we always see an incessant cycle of inflammation and clotting in the body. We are now learning that autoantibodies can be the cause of this cycle of clotting and inflammation that makes people already sicker, ”Kanthi says.
Dr Jason Knight, rheumatologist at Michigan Medicine, who is also an associate professor of internal medicine and a leading expert in diseases caused by autoantibodies, said: “Half of the patients hospitalized for Covid-19 were positive for one. The least of the autoantibodies, which was very surprising. “
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And in the new study, published in the journal Science Translational Medicine, they found that about half of the patients who had severe cases of the Corona virus had a combination of high levels of dangerous antibodies and over-activated neutrophils, which are destructive and explosive white blood cells.
And last April, the team was the first to report that patients hospitalized with severe “Covid-19” had higher levels of extracellular neutrophil traps in their blood.
To find out more, they studied the explosive neutrophils and anti- “Covid-19” antibodies together in mouse models, to see if this was the dangerous combination behind the clots.
“Antibodies taken from patients with active Covid-19 infection created an incredible amount of clotting in animals, which are among the worst clots we have ever seen. We have discovered a new mechanism by which patients Covid-19 can develop blood clots, ”Kanthi explains.
Dr Kanthi, Dr Knight, first author Dr Yu Zhu, and their colleagues now want to know if critically ill patients who have high levels of these antibodies will have better results if the antibodies are blocked or cleared.
If so, it may require aggressive treatment, such as plasmapheresis (the conversion of plasma components outside the body to treat certain diseases), which is commonly used in severe autoimmune diseases, Zhou explains.
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The procedure involves draining blood through a vein, filtering it, and replacing it with fresh plasma that does not contain the antibodies associated with blood clots.
“We know that those with the highest levels of autoantibodies did worse in terms of respiratory function, and that the antibodies caused inflammation even in healthy cells,” says Zoe, associate professor of internal medicine and rheumatologist at Michigan.
Knight adds, “We don’t yet know what causes the body to produce these antibodies, so the next step will be further research to determine the triggers and targets for the antibodies.”
Additionally, these findings raise new questions regarding the use of convalescent plasma as a possible treatment for ‘Covid-19’, but the team says more research is needed to examine this concern.
Knight noted, “We are currently studying how long these antibodies remain in circulation after the novel Corona virus has healed.”
Researchers are currently conducting a randomized clinical trial called DICER, which tests a known anticoagulant agent, dipyridamole, in Covid-19 patients to determine if it is more effective than a placebo at reducing excessive blood clots.
“Dipyridamole is a safe, inexpensive, and scalable older drug. The United States Food and Drug Administration approved it 20 years ago to prevent thrombosis, but we only recently discovered its ability to prevent this specific type of inflammation that occurs in Covid-19 ”, explains Kanthi.
Source: medicalxpress
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