COVID-19
Health
Medical
Medical Research
Medicine
Stroke
Blood Clots
Shortness of Breath
Thrombotic Vasculitis
Heart Attacks
PE
CTPA
Probnp
Clinical Suspicion
Exertional Hypoxaemia
1/ Thank you. I have been saying over and over that #Covid_19 is a thrombotic vasculitis. Now can we start counting the blood clots, heart and attacks and the stroke post-Covid so we can see how bad this is? And GPs- please rule out PE for patients with shortness of breath ππ»
2/ we are finding clots in people months/years after Covid. NICE guidance says do a pro-bnp. Fine-but usually itβs negative. More important is to check for clot with d-dimer. However if clinical suspicion is still strong please arrange a CTPA.
3/ medics If GPs contact you worried about PE please take patient and do a CTPA. If a sit to stand test causes a drop of sats of 4% or more this is exertional hypoxaemia. We are seeing this months after Covid. Donβt rely on outdated VTE scoring systems. #medtwitter #TeamGP
4/ pubmed.ncbi.nlm.nih.gov Dual energy CT depicted proximal arterial thrombosis in 5.4% of patients and perfusion abnormalities suggestive of widespread microangiopathy in 65.5% of patients. Lung microcirculation was abnormal in 4 patients with normal lung parenchyma.
5/ pubs.rsna.org Hyperpolarized xenon 129 MRI and total lung diffusion capacity for carbon monoxide demonstrate significantly impaired gas transfer in non-hospitalized post-COVID-19 condition participants with normal chest CT examinations.
6/ Essentially, even a normal CT does not rule out blood clot(s) If your patient is short of breath and desaturates on 1 min stand test- find the clot.
7/ please listen to this Doctor who specialises is lung imaging. As we learn more we should put it into practice #medtwitter
@DeansKevin this is the imaging info I was telling you about.
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