Over the course of the pandemic, I received many calls from patients and their families. One of the most difficult symptoms to evaluate over the phone is abdominal pain. Most patients, whether at home or in the hospital, need a doctor’s exam to assess acuity, tenderness, peritoneal signs, distension, and incipient gastrointestinal bleeding and/or perforation.
Because the spike protein on the surface of SARS-CoV-2 causes blood clotting, most venous thromboembolic syndromes are seen in both COVID-19 patients and those who took the vaccines. It is my experience that the highest-risk patients are those who have cumulatively been exposed to the spike protein via multiple injections and one or more occurrences of COVID-19 illness.
Zheng and colleagues performed a systematic review of the literature and found 123 case reports of splanchnic vein thrombosis or blood clots in the veins that drain the intestines. This can be a catastrophe causing bowel necrosis, distension, bleeding, gastrointestinal perforation, and death.
There were 75 cases in those who had acute COVID-19, and I anticipate most were critically ill in the hospital with an overall mortality rate of 14 percent. Alarmingly, there were 58 cases of the same problem in those who were vaccinated, presumably well at home, and the mortality rate was 25 percent.
Zheng X, Gao F, Wang L, Meng Y, Ageno W, Qi X. Incidence and outcomes of splanchnic vein thrombosis after diagnosis of COVID-19 or COVID-19 vaccination: a systematic review and meta-analysis. J Thromb Thrombolysis. 2022 Nov 19:1–14. doi: 10.1007/s11239-022-02732-3. Epub ahead of print. PMID: 36402911; PMCID: PMC9676885.The lesson learned from this study is that whether during acute COVID-19 or after taking a vaccine, pay attention to serious acute abdominal pain and distension. Seek prompt care because a blood clot could be the cause of the problem and emergency surgery and blood thinners may be needed. The best way to avoid future risk of abdominal blood clots is to decline COVID-19 vaccination.
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