PATHOLOGY PERSPECTIVES
N e w ! A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 35
Luchau's article "Understanding COVID-
19's Cytokine Storm" in the May/June 2020
edition of Massage & Bodywork (page 80).
A complicated (and very chemistry-
heavy) sequence leads from viral invasion
to cytokine overreaction, inflammation,
platelet activation, and the precipitation of
clotting factors in the complement cascade,
but the ultimate outcome is that the infected
person develops clots—and lots of them.
They can line the alveolar capillaries,
interfering with oxygen/carbon dioxide
exchange. They can develop in the liver, the
kidneys, the brain, and many other tissues.
These clots can damage red blood cells
trying to pass through narrow spaces—a
process that stimulates even more clotting.
All this clotting activity leads to a type of
multiorgan failure, which is a frequent cause
of death for people with the infection. As of
this writing, when a person with COVID-19
dies, this is the situation found during
autopsy somewhere between 30 percent and
40 percent of the time. That number may
change as we learn more about this virus.
But COVID-related clotting disorders
have other repercussions as well. Readers
may be familiar with Tony Award-winning
actor Nick Cordero, whose leg was
amputated because clots in his arteries were
blocking circulation, which led to the threat
of gangrene and blood poisoning. Also as
part of the pandemic, young people (that
is, people under age 50) with the virus are
dying of heart attacks (clots in the coronary
artery) and strokes (clots in the cerebral
arteries) at higher rates than we have seen
before—sometimes before other symptoms
are evident. Further, the clots may be in
unusual places, especially in the brain, and
resistant to typical treatments. This appears
to be directly related to COVID-related
disruptions in blood-clotting mechanisms.
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