*COVID affects the platelets in the blood, making them sticky and causing micro clots that affect the brain, fingers and toes, and internal organs. This article explains the process.*

Updated February 20, 2024

In October 2021, scientists announced a blood factor that may be an underlying risk in Long COVID symptoms and organ damage. The hypothesis is that people with Long COVID have higher blood levels of Alpha 2-antiplasmin, a serine protease inhibitor responsible for inactivating plasmin. In other words, COVID can make platelets too sticky, because plasmin is an important enzyme that helps break down clots.

The Physiology of Fibrinolysis & Clotting

Fibrinolysis means the breakdown of fibrin, a material involved with clotting to stop bleeding when you get cut. It is part of the process of coagulation, ensuring that clots that are formed in response to injury get broken down after the injured tissue is repaired, like when a scab falls off a cut.

In simple terms, fibrinolysis is the process of breaking down blood clots in a healthy body. The presence of Alpha 2-antiplasmin interrupts the fibrinolysis process, therefore, micro clots remain intact with the potential to damage organs and cause things like ministrokes.

In healthy people, the presence of the Alpha 2-antiplasmin blood factor helps to prevent hemorrhage and clotting of blood that is in circulation.

A micro embolism is a small blood clot (micro clot), that can get caught in the bloodstream and can cause a blockage in a blood vessel. This can occur anywhere in the body, but when it happens in an organ such as the brain, kidney, liver or other organs, it causes damage and tissue death.

Most people are familiar with the idea of a stroke that is caused by a blood clot in the vessels of the brain, so we will use this as an example. When micro clots accumulate in the vessels of the brain, they are known as cerebral micro emboli. A large number these micro emboli may cause damage in the form of a transient ischemic attack (TIA), referred to as a ministroke, micro stroke or "warning stroke." Frequent micro emboli may indicate a high risk for a future large blockage (embolus) or stroke.

A stroke occurs when a blood vessel that supplies blood to the brain is blocked (ischemic stroke), leaks or bursts (hemmorhagic stroke). When the blood cannot flow through the brain, the brain tissue (neurons) on the other side of the clot becomes oxygen deprived causing brain cell damage or death. As a result, the part of the body controlled by the damaged area of the brain cannot work properly.

COVID-19 CONSIDERATIONS

COVID-19 infections can present with prominent elevation of D-dimer and fibrin/fibrinogen-degradation products. Abnormalities in blood levels of the prothrombin time, partial thromboplastin time (PT/PTT lab values) and platelet counts are relatively uncommon in initial phases of infection.

Coagulation test screening, including D-dimer and fibrinogen levels, is recommended.

COVID-19 associated coagulopathy should be managed as it would be for any critically ill patient, following the established practice of using anticoagulant therapy.

A consistent observation among patients with Covid-19, particularly those with severe illness is an elevation of D-dimer. The presence of D-dimer in the circulation signals the breakdown of fibrin polymers by plasmin.

What does this mean?

Severe cases of acute COVID-19, typically seen in hospitalized patients, is correlated with a hemodynamic status relating to the flow of blood within the organs and tissues of the body. In severe cases COVID-19 can cause a hemodynamic crisis called DIC. In less severe cases this situation may be observed in petechiae, bruising, blood clotting and stroke.

What to do?

Keep your doctor informed of any purple pinpoint spots that appear on your lower extremities, unusual bruising, or events like blue, purple or black fingernails, toenails, or lips. If you notice symptoms of dizziness or numbness, contact your doctor. You may be referred to a hematologist, or a prescribed anticoagulant medication to prevent deep vein thrombosis, blood clots or strokes.

At home you can help yourself by stretching, walking and moving every hour to keep your blood flowing, stay well hydrated, and research foods that may influence blood clotting. A few common foods common foods that are associated with decrease blood clot risks are garlic, ginger, cayenne pepper and turmeric. Aspirin is also has known to have anticoagulant qualities. You should always speak to your doctor before using any of these options to address concerns of blood clotting.

Most importantly, educate and advocate for yourself and help your doctor help you.

Things you can do to help yourself

Minimizing physical & psychological stressors is essential in recovery from Long COVID.

Nutrition: Try to eat protein and fresh vitamin rich foods daily and avoid chemicals, preservatives, sugars, fast foods, prepared foods and high histamine foods.
Don’t skip meals. Your body needs protein, vitamin C, and vitamin D to heal from any injury or illness. A low histamine or low carbohydrate (sugar) diet is recommended by doctors treating Long COVID (PASC), and many people report a reduction in symptoms within 1-3 days of the diet change, including decreases in sneezing, itching or hives, irritable bowel syndrome, body pain, along with a reduction in swelling and inflammation.
Hydration: A minimum of eight 8 oz glasses of plain water daily is recommended.
Avoid drinks with chemical additives. You can easily make a fresh electrolyte drink yourself by adding a dash of mineral rich Epsom salt and a piece a fruit like a raspberry for flavor instead of spending money on commercial drinks like Gatorade that contain chemicals and sit in plastic bottles for long periods of time. Remember that caffeine and alcohol have dehydrating effects.
Sleep hygiene: Getting 7-9 hours of sleep so your body can repair itself. You need at least 4 hours of uninterrupted sleep to get into the restorative phase of sleep.
Avoid stimulating activities after dinner like thrilling movies or books, arguments, negative news or frustrating stimuli.
If you wake up frequently or with a startle, you may be experiencing drops in your oxygen level, which signal your brain to release adrenaline to force you to take a breath. This could be a temporary inflammation issue or more enduring sleep apnea. Ask your doctor for a sleep study to evaluate your need for a CPAP or BiPAP, a machine that pushes air into your lungs when it senses an apneic episode (periods of not breathing).
Stress management: Stress affects every component of your life.
The only thing you can control about stress is your reaction to it. Try to avoid or minimize your exposure to stressful situations: Turn off the news, make family visits that end unpleasantly short, wait for the morning to have intense discussions, let go of things that annoy you but don’t really matter in the big scheme of things, avoid intense conversations or entertainment in the evening.
Exercise within tolerance: Pace yourself and do not push your body to extremes in any way.
For some this may mean seated breathing exercises, walking to the mailbox. Rest when your body says to slow down. Gradually build on your activity endurance as your body cues you to progress. This can be hard to gauge, because when you feel good you naturally do more, but if you do too much you may experience symptom flare ups 1-3 days later as the post exertion inflammation builds. Some people describe this as post exertional malaise, others experience severe recovery set backs.
Breathwork: You can literally stop the fight or flight reaction by taking slow deep breaths.
Deep slow breathing shuts down the adrenaline flow, slows your heart rate, lowers your blood pressure and decreases stress related histamine release. When you do this, your blood reroutes back to your brain and nervous system to allow you to think clearly. It also allows your body to use its energy and oxygen to heal your inflamed nerves and organs.

Long COVID Support

**ProMedView** **Nurse Coaches - We get it.**

Our clinical experts advocate for those with Long COVID.
Individual coaching
Group Q&A sessions
Peer support groups
Educational webinars

Learn More

Keep moving, keep breathing.

Brought to you by covidCAREgroup, connecting the dots of long COVID through education, research and resources.

Did this article help you? Please consider making a gift, donating, or purchasing a $25 annual membership. The covidCAREgroup is run by volunteers. 100% of our funding comes from community donations are used to support our continued outreach initiatives.

Give support

COVID Care Group, LLC, is not a “not for profit” organization. Donations, gifts & memberships are not tax-deductible.

COVID Care Group, LLC is not a healthcare provider and does not provide medical advice, diagnosis, or treatment.