Blood clots, heart attacks, and strokes are often the ways COVID kills the apparently healthy

The other day I mentioned the disturbing number of young, otherwise healthy patients with apparently only very mild cases of COVID-19 unexpectedly having strokes and sometimes dying.  As a man about to turn seventy who has had high blood pressure his entire adult life and recently learned that he has had a "silent" heart attack, I long since took note of another disturbing if under-reported peculiarity of this disease: 40% of those who have high blood pressure and are hospitalized with COVID apparently have heart attacks or strokes at some point in their hospital stay.

What seemed at first to be primarily a pulmonary disease turns out to attack virtually every organ of the body- not only the lungs but also the heart, kidneys, liver brain, and even the toes. Yes, the toes. "COVID toe" is a strange syndrome in which lesions appear on the toes of victims, especially children.

This is one weird, spooky disease. 

We heard going into this pandemic that only a very small percentage of those infected with the virus became seriously ill.  Only the very sick were hospitalized. We were reassured by the knowledge that the reported mortality rate for COVID was surely much too high, perhaps by a factor of five or more, since most cases go unreported. As ominous as it is for other reasons, the news that many and perhaps most of those afflicted by the sickness literally never know that they've been sick because they exhibit no symptoms whatsoever seemed to indicate that whatever else might be the case with this extraordinarily communicable plague, it really wasn't all that lethal.

But now, we have to wonder. At some point, studies are going to have to be done to determine whether and by how many deaths due to heart attacks, strokes, and other maladies have exceeded the norm during this pandemic, and whether the overage might not wisely be added to the COVID death toll. In any event, in recent weeks doctors are becoming more and more aware of frequent and often lethal clotting problems even in patients who seem to be young or middle-aged, relatively healthy, and well on the way to recovery.

This is not a disease that is only mortally dangerous to the old and frail, and any illusions to that effect we may ever have had to that effect is rapidly dissolving in a flood of cases involving people who weren't supposed to be at any real risk. One wonders whether the willingness of some younger folks to be willing to sacrifice the lives of a few oldsters in an illusory attempt to lessen the burgeoning financial crisis by opening up the economy more and earlier than doctors consider wise might waver a bit as it becomes clearer and clearer that they, too, are in peril of their lives, no matter how good they might feel or how healthy they might assume themselves to be.

Efforts have been made to keep accurate track of the number of deaths which ought to be attributed to COVID by using stringent diagnostic criteria. But there is a subjective element here. Just how much of a role does the virus have to play in the death of a sickly, elderly man or woman before it, rather than what perhaps might have been a serious underlying condition, becomes the cause of death? The lunatic fringe is seeking to use a CDC memo suggesting less obsessive straining at metaphorical gnats in designating COVID as a cause of death, especially a contributing cause, as an attempt to inflate the death toll for some undisclosed reason. Actually, the new criteria are more in keeping with what have usually been used in keeping track of deaths due to the seasonal flu and other sicknesses.

But in addition to the question of how many people recover from COVID cases that were never reported, we now have to wonder how many deaths due to seemingly prosaic things like heart attacks and strokes among people who had never been tested and who there was no reason to suspect had contracted the virus are actually COVID deaths.

There is a video on YouTube of a man holding a small brandy snifter of human blood into which he placed a single drop of the hemotoxic venom of Russell's viper, a deadly snake that lives in south-central and southwest Asia. After swirling the envenomated blood around a few times, he pours it into a Petri dish- where it is seen to have been changed into something resembling cranberry sauce. A similar image comes to mind when I consider what a New York doctor who has been treating COVID patients told The Dispatch:

I’ve heard stories of where we draw the blood from the patients—usually, you have maybe a minute to put the blood in the test tube before it starts to clot, and it’s like clotting as we draw it... There’s cases where the patients seem to be doing fine in terms of the virus and are getting better, and all of a sudden they can’t breathe, and we look and find a blood clot in the lungs.

Even during the early days of the outbreak in Wuhan and environs, the number of people stricken by the illness who developed blood clots was remarked upon.  And in this crisis, we're battling a novel disease which seems to reveal a new and frightening aspect of itself almost on a regular schedule.

In this case, it seems to be an aspect the Chinese recognized even in the earliest stages of the pandemic, and which the healthcare professionals have remarked upon all along. But it seems to only be dawning on most of us outside the frontlines of the battle against this pandemic that COVID-19 is a threat to the circulatory systems of the young and healthy as well as to the lungs of the old and frail.