MONTGOMERY, Ala. (WSFA) - As a cardiology research fellow at UAB, Dr. Vibhu Parcha is treating some of the sickest COVID-19 patients. “It was almost instantaneous that we started to know that almost every COVID patient that was admitted was having some derangement in their clotting profile,” Parcha stated. Universally, COVID patients are being admitted to UAB with blood clotting issues, a manifestation of the virus. Even those who are very healthy aren’t immune. While some patients develop blood clots as the virus progresses, others are admitted after suffering from a stroke or heart attack brought on by the virus. “Young patients are coming in with no comorbidities and they’re coming in with strokes and kidney failure, a lot of patients who do develop strokes do not completely recover,” he explained. “It’s staggering.”
Parcha says he recently treated a 30-year-old who attempted to fight the virus at home. Due to clotting issues, he now has permanent heart damage. Parcha says if the patient had come in three days earlier, it could have changed his life. “We’ve had a range of patients that we’ve seen,” Parcha said of the patients’ ages and health conditions. “We had a 35-year-old guy who had a five kids, he was doing really well before the pandemic came in. He was admitted with us, we took very good care of him. We tried our best. He was with us in the intensive care unit. He did not make it.” Most of the blood clots are in the lungs, but also impact other major organs. Some doctors go as far to say COVID-19 is one of the most clot-producing diseases they’ve ever treated. “As more data and evidence accumulates we’ll have a better understanding of what regulates the fact that some have higher manifestations of the clotting disorder, while others don’t,” he said. Parcha explained that some of the patients who are taking blood thinners for other health conditions prior to contracting the virus can have better outcomes.
“There is some anecdotal evidence which suggests that people who are on anticoagulants or who are given systemic anticoagulants seem to do better, especially in intensive care settings,” he said. Parcha’s currently enrolling patients in a trial that uses nitric oxide to help the gases in the lungs transfer properly after the overall lung function is decreased by COVID-19. “This is primarily because the blood supply to the functional portion of the lungs is restricted by these micro-clots, which is making parts of the lung nonfunctional so if there is no blood supply to the small portions of the lungs called alveoli,” he explained. “So the functional capacity of the lung goes down and that kind of manifests as the entire lung disease spectrum of the COVID-19.” During the SARS outbreak, researchers found that nitric oxide helped treat similar clotting issues and it killed the virus, which is promising. UAB is expected to enroll more patients in the study than other participating facilities. He says enrollment is ahead of schedule due to the volume of sick patients admitted to the hospital. If severely ill COVID-19 patients are fortunate enough to recover, it’s unclear whether they will continue to experience clots and if the organs that were damaged by the clotting disorder will heal.
“We don’t know what the impact these clots have had on patients' cardiac function, how their heart is functioning, or how their brain is functioning,” Parcha explained. “We would see an impact of that in the coming time.” Parcha sees the best and the worst outcomes of this disease on a daily basis, something that weighs on the entire medical community. “Those instances affect us, these are our peers - some are our age,” he said of the patients. “These people are just going about their daily activities and they were badly affected by the pandemic. We’re seeing multiple members of the same family admitted in the hospital. (continued)