Covid-infected woman needs three fingers amputated

A Covid-infected woman had three fingers amputated after the disease ravaged her blood vessels. 

Gruesome pictures published in a medical journal showed how the unidentified 86-year-old’s digits turned black.

Doctors in Italy, who had to cut off her gangrenous fingers, called her case a ‘severe manifestation’ of coronavirus. 

Covid has been found in many patients to cause severe damage to blood vessels, causing dangerous blockages known as blood clots.

While experts are unsure why the virus causes the blockages, the prevailing theory is that it is the result of an immune overreaction called a ‘cytokine storm’, which sees the body attack healthy tissue.

It is believed the Italian patient had suffered blood clots which cut off supply to her fingers.   

Gruesome pictures published in a medical journal showed how the unidentified 86-year-old’s digits turned black

When the immune response goes into overdrive, it can damage healthy tissue. if blood vessels are affected they can leak, causing blood pressure to drop and driving up the chance of clots forming.  

It is not the first time a Covid patient has needed their fingers amputated. 

A 54-year-old man from Studio City, California, had two fingers amputated as a result of extensive tissue and muscle damage after contracting Covid on a ski trip with a group of friends in northern Italy last February. 

Meanwhile a father-of-two, from Cardiff, Wales, lost his left thumb, a forefinger and a half a finger last year after he contracted coronavirus and spent 61 days on a ventilator.

The Italian woman’s grisly case was revealed in the European Journal of Vascular and Endovascular Surgery.

She was put on blood-thinning drugs last March after doctors noticed she had a lack of blood flowing into her heart — which is normally triggered by a heart attack or stroke. 

The drugs prevent platelets, blood-clotting cells, from clumping together. 

Doctors in Fermo, situated on the Adriatic coastline, 155 miles (250km) north of Rome, swabbed her for coronavirus because of the pandemic and the result came back positive. 

However, she had no common symptoms of coronavirus, including a fever, cough, loss or change in smell or taste. 

A month later, she went back to hospital after her index, ring and little finger on her right hand had turned black.   

She had developed dry gangrene which results when the blood flow to a certain part of the body becomes blocked.    

In order to understand what was causing the gangrene, she had a scan to look at the speed of blood flow through her body. 

Medics found she had low pressure in the common digital arteries, which are small vessels that travel through the palm of the hand before splitting to provide blood to the fingers. 

Doctors gave her heparin, an anti-coagulant medication used to prevent blood clots and treat heart attacks. Surgeons then amputated her three fingers.

Experts examined the dead tissue under a microscope and saw signs of intravascular thrombosis.

Thrombosis is when blood clots develop in the arteries and veins, which can block the heart (causing a heart attack), brain (a stroke), or lungs (pulmonary embolism).   

Blood clotting involves a series of steps, the first of which is known as ‘activation’ which occurs when platelets clump together.

Professor Graham Cooke, involved with the National Institute for Health Research, a research arm of the NHS, said: ‘It’s important to note Covid is a multi-system disease.

‘I think one of the features that seems to separate it from other severe viral disease is this more hypercoagulable state that seems to be associated with later disease.’

A hypercoagulable state occurs when the blood is clotting more than necessary, and can be part of a blood disorder or triggered by medications, cancer, heart attacks or HIV, for example.

It’s dangerous because it can lead to the formation of a blood clot in the veins which can travel through the bloodstream and cause deep vein thrombosis — a blood clot in the veins of the pelvis, leg, arm, liver, intestines or kidneys.

It can also cause a pulmonary embolism — a blood clot in the lungs — and raise the risk of stroke, heart attack, severe leg pain, difficulty walking, or even the loss of a limb.

Doctors say they have noticed a considerable amount of Covid-19 patients with blood clotting problems, sparking concern the disease is a vascular infection as well as a respiratory one.

Professor Roopen Arya, from King’s College London, estimated in May that as many as 30 per cent of coronavirus hospital patients had blood clots.

‘I think it has become apparent that thrombosis is a major problem,’ he told the BBC.