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Dr Mark West

The unusual occurrence of strokes among youths battling COVID-19 is yet another reason to prevent the virus’ spread – because local authorities haven’t yet instituted treatment for these strokes.

Plus, in some bad COVID cases, air escapes the lung into the skin, giving the patient an inflated “Michelin Man” look. And if you have to go on a ventilator during treatment, it’s a last resort and there’s a high chance of death.

Consultant/cardiothoracic surgeon at the Eric Williams Medical Sciences Complex in Mt Hope, Dr Mark West, shared the information at yesterday’s Ministry of Health Ministry media update.

On Monday in Parliament, Health Minister Terrence Deyalsingh spoke of the latest discovery that youths with COVID were suffering blood clots and “people are dying” in response to UNC MP Fuad Khan’s call to reopen food businesses. Deyalsingh said the blood clot development had thrown a “spanner into the works” and Government would take decisions only on scientific data.

Yesterday, West said COVID-19 is a killer affecting respiratory and “just about every other system”, including thickening blood. He said while strokes occur in older people for different reasons, COVID patients of all ages are showing blood clots and strokes – and that’s unusual in youths.

“The virus is acting in some way to create high viscous blood flow to the brain,” West said, adding if patients were lucky they survived.

West said T&T hasn’t yet instituted preventative treatment against blood clots but noted it’s not yet widespread.

He said patients are usually given drugs and sometimes steroids to reduce inflammation, “but preventive treatment of strokes isn’t among the treatment”.

He said it may be that T&T doesn’t have randomised trials to show benefits of such treatment but work’s done on a case-by-case basis – cautiously.

“T&T’s been very lucky and done very well but there’s risk of reducing vigilance and we may see a rise in cases. We must maintain vigilance,” West added.

Deyalsingh said Government’s using a careful path with the new development regarding strokes in youths.

“I hope what Dr West said reinforces in the public mind that what Trinidad and Tobago’s doing is correct. Stay home, wear masks.’’

West also reminded the public of how serious the virus is, the need to prevent it and what some patients endure.

Speaking about a COVID case which was managed at Couva Hospital, West said the patient was an elderly, male non-smoker, displaying a mucus-rich cough, shortness of breath and fatigue. He had no travel history but was in contact with a COVID patient who was on the cruise ship where passengers fell ill. The man also had hypertension, diabetes and chronic kidney disease. He went to the Arima hospital, was transferred to Mt Hope, then Couva when shortness of breath worsened.

He was put in the High Dependency Unit and medical equipment was inserted into his chest to assist oxygen intake. West showed slides of lung collapse where air escaped into the chest cavity and couldn’t exit the body. Another slide showed further complications, with air leaking outside the man’s chest into his skin. This blows up the appearance, creating a “Michelin Man” look, West added.

West said tubes were inserted in the man’s chest to drain the air.

“His oxygen settled down and distress decreased – he improved. He was going the wrong way and was going to end up on a ventilator. But he recovered, was eventually removed from HDU into a general ward and later walked. After two negative tests, he was discharged.”

But West added not all cases go well. He showed more slides with severe COVID effects on a patient’s lungs and pneumonia. This causes severe respiratory problems – requiring ventilator support – and overwhelming inflammatory response, often causing death.

“We may have been heading to this with the first patient but I’m delighted to say we didn’t. We were lucky,” he said.

Very sick patients require ventilators to keep oxygen in their system and could probably die without it. “Ventilation may be necessary but it’s a last resort,” he said.

In the process, a tube is passed through a patient’s airway and attached to a ventilator, moving air into the lungs. In some instances, those whose lungs are already damaged don’t survive.