While doctors have been urging the government to provide enough supplies of personal protective equipment (PPE), they are now running out of dialysis machines and supplies.
Emergency room doctors are struggling to treat COVID-19 patients who are going to kidney failure and developing blood clots due to a lack of dialysis machines.
They said the body’s intense reaction to the coronavirus is causing the patients’ blood to clot too much, and the clots are getting clogged up in the dialysis filters.
The doctors are seeing this as a new syndrome in COVID-19 patients. They said patients are not dying from pneumonia, which has been the characteristic problem of deadly COVID-19 disease, but from other complications, such as kidney failure and heart failure.
Critical care specialist Dr. Sam Parnia at NYU Langone Medical Center said, “It’s taken everyone by surprise because it is acting so different from everything else. They are not dying because they can’t get enough oxygen. They are actually dying because of other complications and it is predominately due to blood clots.”
These blood clots are getting accumulated in the filters that are used to clean the blood during dialysis, Dr. Parnia and other doctors told CNN.
ICUs have already been struggling to get enough dialysis machines and health workers to care for COVID-19 patients and this crisis has made things worse.
“There aren’t enough filters,” Dr. Parnia told CNN.
Another ICU specialist Dr. Enrique Lopez from Phoebe Putney Health System in Albany, Georgia, said he has been facing the same difficulty.
He told CNN, “Their blood does not clot appropriately. It’s over-clotting. When we put patients on dialysis, they have a tendency to clot the filters.”
The body’s intense immune response to the virus is causing a cytokine storm, which is responsible for blood clotting. And some COVID-19 patients are having this intense immune response, resulting in blood clots in the kidneys, liver, heart, and even the brain.
“When people are reporting on autopsy results, they are seeing clots everywhere in the body,” Dr. Parnia said, suspecting that the blood clots are leading to kidney damage.
Nephrologist Dr. David Charytan of NYU Langone Health said there is also evidence the virus has directly been attacking the kidneys. “The result is a much larger need for dialysis than normal in ICUs already filled to overflowing with COVID-19 patients,” he said.
“One day, last week, we had 186 patients intubated with COVID,” Dr. Charytan said, which means they were attached to ventilators to help patients breathe. “It’s been a real struggle,” he added.
“You have to try to decide who’s going to get dialysis and who’s not,” Dr. Lopez said. “We are trying whatever we can.” Some doctors are using blood thinners or anticoagulants, such as heparin, to reduce blood clotting. However, there is not enough evidence to show whether such drugs help patients to survive.
