Older adults face a myriad of health risks, and the global COVID-19 pandemic adds another layer of complication. No one knows this better than senior living and skilled nursing caregivers.

Our familiarity and alertness to the signs and symptoms of COVID-19 can make residents and patients susceptible to misdiagnosis in cases where another ailment shares similar symptoms, such as blood clots.

COVID-19 and blood clots share several common symptoms, such as rapid heart rate, shortness of breath, skin discoloration or loss of consciousness. Because people with COVID-19 present with a wide array of symptoms that vary from case to case, it may be difficult to determine whether those symptoms result from the virus or something else. That delay in diagnosis can have serious consequences for people with blood clots.

Here are some ways to identify whether a patient has a clot or COVID-19.

Understanding blood clots

Blood clots — or venous thromboembolism, or VTE — is a leading cause of death and disability worldwide and accounts for up to 300,000 deaths in the United States each year. Blood clots most often form in the deep veins of the limbs or groin, called deep vein thrombosis, or DVT, and can travel through the circulatory system. A clot becomes lodged in the lungs is called a pulmonary embolism.

People aged 60 or more years are at a higher risk for blood clots. Risk also increases with obesity, smoking, alcohol consumption, some cancer treatments, trauma, extended hospital stays or bedrest, and other factors, including COVID-19 infection itself. 

Symptoms of blood clots

Although some blood clot symptoms may have similarities to symptoms of COVID-19, several symptoms differentiate blood clots and can help speed diagnosis:

  • Localized pain or tenderness: In cases of DVT, a person may experience pain or tenderness at the site, often starting in the calf.
  • Swelling:  DVT also can cause swelling in the ankle or foot.
  • Localized warmth: Although someone may be feverish or warmer than usual while ill with COVID-19, in cases of DVT, warmth is localized to the area of the blood clot.
  • Chest pain: In cases of pulmonary embolism, in which the clot has traveled to the lungs, the person may report chest pain that worsens with deep breaths and/or coughing up blood.
  • Light-headedness: PE can also cause lightheadedness, which may result in a person passing out. This is distinct from COVID-19 patients, who may experience an energy drain, struggle to remain awake and lose consciousness.

Swift action can save lives

With the pandemic top-of-mind among senior living and nursing home caregivers, it’s not surprising to default to a COVID-19 diagnosis. Familiarity with the unique symptoms of blood clots, however, can be a quick differentiator that can save lives.

VTE is serious but can be treated if caught quickly. Treatment typically includes anticoagulants to break up the clot and prevent additional clot(s) in future.

Although older adults are part of a high-risk demographic for blood clots, swift action can allow the patient to not only survive, but to lead an active and fulfilling life for years to come.

Lana Castellucci, M.D., FRCPC, MSc, is an assistant professor in the Faculty of Medicine at the University of Ottawa and a scientist at the Ottawa Hospital Research Institute in Canada. She serves as a member of the World Thrombosis Day Steering Committee. Additionally, she sits on the Board of Directors of Thrombosis Canada, a national organization promoting patient education and improved outcomes for patients with venous thrombosis. She is an active member of the CanVECTOR (Canadian Venous Thromboembolism Clinical Trials and Outcomes Research) Network, and recipient of the Heart and Stroke Foundation of Canada National New Investigator Award.