One of the most fascinating and ominous things about COVID19 is that as clinicians and researchers have learned more about it that knowledge has not simply filled out the details of a broadly understood story. Rather, more knowledge has confirmed how little we knew and still know about the disease. For lay people like most of us the original story was that COVID19 was a viral respiratory tract infection. It was more deadly, less predictable in its course and had no known therapies to treat it. But broadly speaking a disease that attack the lungs, leads in severe cases to pneumonia and from there a cascading series of failures that can lead to death. Doctors had a more sophisticated but broadly comparable understanding. Four months plus into the history of the disease they know that COVI19 can attack most of the body’s major organs – heart, liver, kidneys, brain, et al. It’s far more insidious and copious in its range of potential attacks on the human body than they realized only six weeks ago.

A new emerging issue is how COVID19 attacks or disrupts a patient’s blood – specifically the delicate and critical balance of regulating when to flow and when to clot. When I first read articles about this I assumed these clotting issues were just part and parcel of the failure or near failure of the various organ systems. COVID19 attacks your liver or kidneys and clotting issues are just a manifestation of injury. But that does not seem to be the case. It seems to be a distinct way COVID19 attacks the body.

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