Pandemic Lessons: Telemedicine, Coagulopathy and Lymphatics
Telemedicine as the New Normal
Ruth Bush reviewed data showing telemedicine reduced travel burden and exposure risk, with varicose vein patients reporting high satisfaction with virtual follow-up, prompting CMS to add 85 telehealth services at in-person reimbursement rates during the pandemic.
COVID-19’s Tangled Hemostatic Web
Joseph Caprini described COVID-19 as triggering a cytokine storm that activates coagulation, fibrinolysis, complement, and inflammation together, in what Oscar Ratnoff termed the tangled hemostatic web, producing thrombosis throughout the pulmonary and systemic vasculature.
Anticoagulation Intensity: Guidelines and Trials
Society guidelines favored prophylactic dose anticoagulation based on low certainty evidence, but a multiplatform randomized trial found full dose anticoagulation reduced organ support needs and mortality in moderately ill hospitalized patients, reinforcing individualized, risk based dosing.
Does COVID-19 Reach the Lymphatic System?
Stan Robertson found lymphatic tissue expresses almost no ACE2 receptor, the virus’s entry point, suggesting little direct lymphatic involvement in COVID-19, though the lymphatic system’s role in immune trafficking and glymphatic drainage may still contribute to neuroinvasion.
