The role of tiny blood clots in long-term COVID: NPR

The role of tiny blood clots in long-term COVID: NPR

Michel Martin of MediaFrolic speaks to researcher Resia Pretorius of Stellenbosch University in South Africa about the key role of micro clots in the diagnosis and treatment of long-term Covid.


We are now going to turn to one of the greatest medical secrets of the coronavirus pandemic. There is talk of long-term COVID. Patients who suffer from it report a variety of symptoms that persist for weeks or months after recovering from an initial COVID infection. These symptoms can include fatigue, brain fog, breathing problems, depression, and even hair loss. According to researchers from the University of Michigan, up to 100 million people around the world have or have long had COVID. But doctors still don’t know much about the disease.

This is where our next guest comes in. Resia Pretorius is Professor of Physiological Sciences at Stellenbosch University in South Africa. She and her colleagues have been analyzing blood samples from long COVID patients since the beginning of 2020. And they discovered that many samples have something in common, micro-clots. So could these tiny blood clots help researchers better understand long-term COVID-19 and possibly even devise ways to treat it? Professor Pretorius is with us now to tell us more. Professor, welcome. Thank you for talking to us.


MARTIN: So your research suggests that micro-clots could play a key role in understanding long-term COVID-19. Could you tell us a little more about what they are and how that might explain some of the symptoms long-time COVID patients have, especially the ones we hear about the most, like fatigue and brain fog?

PRETORIUS: Sure. In my opinion, if we are talking about long COVID and micro-clots, we should just step back for a second and talk about acute COVID. We have found – we and others have found that the vascular system and blood clotting do not function properly during acute COVID. So the dilemma with long-term COVID is that the percentage of people, up to 30%, never really overcome the presence of these coagulation disorders or physiological abnormalities when they are no longer infectious – that is, when they are the normal five to ten days of. survive acute COVID. Then, during long COVID, these clots will simply continue to exist.

MARTIN: Do you have a feeling for why these micro-clots don’t break down like blood clots normally do in healthy people?

PRETORIUS: The micro-clots that are present in these people’s blood have various trapped molecules, inflammatory molecules, that actually prevent the micro-clots from breaking down. So, although the body tries very hard to break down these clots using normal physiological processes, molecules trapped in the micro-clots actually prevent them from breaking down.

Well, that’s a massive problem because when these micro-clots circulate they damage the vasculature or your blood vessels and in the process prevent the cells from getting enough oxygen, resulting in failure of the oxygen coagulation system to your cells. And that can be linked to all of the persistent symptoms seen with long-term COVID.

MARTIN: Do you think your research could allow laboratories to detect long-term COVID in patients’ blood and help doctors diagnose the condition? And one of the reasons I ask is that when we’ve interviewed people who have had COVID for a long time, one of the things they talk about is that people don’t believe them. And they struggle with this sense of shame, which for some people is almost as devastating as the condition itself. So do you think work would help people navigate a diagnosis that people would accept – not just medical Community, but the people – would normal people accept or would employers accept for people to do this? Don’t they feel like they are constantly struggling against this feeling that they are simulating, for example?

PRETORIUS: That is exactly one of the great dilemmas that the millions of people who suffer from long-term COVID face every day. You are really seriously ill. And if they go to a pathologist or their clinician and they do blood tests regularly, all blood tests are usually brought back in the healthy range. And that’s why many of the clinicians themselves say that these individuals suffering from long-term COVID are all psychological. And that’s a big dilemma.

Just because we don’t have a simple, available diagnostic marker for COVID for a long time, doesn’t mean the disease doesn’t exist. So this is one of the most important key factors. So what we are – we and others, not just in South Africa, but a whole team of researchers and interested clinicians are working very hard to get the diagnosis that will allow us to detect floating microclots. Only when we have a diagnosis can we think about treatment regimes.

MARTIN: And of course the treatment would then be something that would be of great interest to us. Does your research show some options for treating long-term COVID? Can you tell us something about that?

PRETORIUS: So one of the dilemmas with any treatment, whether you’re talking about long-term COVID or acute COVID or any other condition, is that the general clinical community only believes data that comes from clinical trials. And right now there are no real clinical trials that focus on long-term COVID-19. We are working on this with a group of US and UK researchers. And we’re trying to get tries to see which conditions work and which conditions don’t. That is the most important thing that is needed. But for that we of course need funds and a very large infrastructure to be able to conduct clinical studies.

MARTIN: And that leads me to my next question, which is that, as I mentioned earlier, an estimated millions of people have, or have had, COVID for a long time. And with this current twist, this current surge fueled by this newest twist, it only seems logical that that number could go up. So much attention worldwide has focused on vaccines – and rightly so – and thereafter, of course, on therapies. And rightly so. But do you think it is time that the nature of research, attention, and resources in the world perhaps switched to the long Covid system?

PRETORIUS: Absolutely. So, as you mentioned earlier, the focus was rightly on keeping people out of the hospital. And our health facilities were really extremely stressed. The dilemma is that many of the longtime COVID patients are at home and are therefore neither seen nor heard from. And they fight alone. That is why I think it is so, so important, to turn our attention now to research and turn it to these very, very sick patients, because if we don’t do that in a few months, our economy will see the consequences and have a serious impact on ours Economies worldwide.

MARTIN: That was Resia Pretorius, professor of physiological sciences at Stellenbosch University in South Africa. We reached them on Skype. Professor Pretorius, thank you for sharing this expertise with us today.

PRETORIUS: Thank you for asking me.


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Rachel Meadows

Rachel Meadows

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