Covid-19 and thrombosis: Misinformation that flew around the world

Starting from early April, a long message began circulating online – in a variety of languages and countries, both in Europe and abroad – claiming that Covid-19 is actually a thrombosis and not a case of pneumonia. The discovery was linked to Italy, as it would be the result of a number of autopsies performed by Italian experts on deceased patients who tested positive for the new coronavirus.

The fake news quickly became popular and it has been shared thousands of times on social media, most of all on Facebook and Whatsapp. On May 12 the International fact-checking network (Ifcn) has also included it in its Top 5 most common examples of disinformation about the new coronavirus since the beginning of the pandemic.

Variations of the message, published originally in Italian, were detected in different languages such as Greek, Spanish, and English. However, the main arguments remained the same across countries and idioms.

Let’s see more in detail the content of the viral message, before analysing where and when it was spread.

The thesis: Covid-19 is not pneumonia, but thrombosis

The viral message stated that the new coronavirus wouldn’t have anything to do with interstitial pneumonia, but it would actually represent an instance of disseminated intravascular coagulation.

Therefore, the message goes on, the thousands of Covid-19 related demises would be due to venous thrombosis, and not to pneumonia or respiratory problems. This in turn would call for a complete re-evaluation of the health protocols implemented by hospitals worldwide, as pneumonia would be a «diagnostic error» and Covid-19 would be curable at home with antibiotics, anti-inflammatories, and anticoagulants.

Where does the message come from?

The message originally started circulating in Italy. The earliest version we could find dates back to April 10, 2020. It was shared by Giampaolo Palma, a cardiologist who operates in Nocera Inferiore (a town not far from Naples) on his personal Facebook profile.

It spread through several European countries in April and May. Our colleagues from VOST Euskadi, an association of volunteer fact-checkers from Basque Country (Spain) analyzed this issue on May 1 for the Basque public television network Eitb. They reported that a message which linked Covid-19 and thrombosis started circulating on Whatsapp «in the last few days,» thus referring approximately to the end of April.

Our Greek partners from FactChecker.gr also told us that the news started circulating in Greece on May 26, through a Facebook post which has already been shared hundreds of times.

The message became popular in Germany through a Whatsapp chain that circulated in late April; in the United Kingdom with a Facebook message posted on May 3; in France on May 8, and in Ireland in late May. The news has also crossed European borders reaching India, Latin America (Argentina, México, Ecuador,) and Canada.

As we said the message was formulated in different ways, but all the posts that went viral link the alleged “eye-opening” discovery to Italy, where a medical team would have performed a number of autopsies whose results led to defining Covid-19 as a thrombotic problem instead of a pneumonia.

Let’s see what we know about these claims.

Is it true?

We tried to shed some light on the content of the viral message by gathering official information from authoritative sources in the medical and scientific international community. We used as a benchmark the earliest available version of the message, shared by Giampaolo Palma on April 10.

Even though the claims supported by the message are not completely made up, they are presented in a largely inaccurate way and, in some cases, they are disproven by official accounts.

A «diagnostic error»?

The viral message claims that defining Covid-19 as a pneumonia is a «diagnostic error», because the real cause of death is venous thrombosis. This statement is not correct or, at least, it’s not supported by the scientific community.

The new coronavirus is widely recognized as a respiratory infection. According to the European Centre for Disease and Control (Ecdc), for instance, its most common symptoms are «fever (88%), followed by dry cough (68%), fatigue (38%), sputum production (33%), dyspnoea (19%), sore throat (14%)». Additional evidence comes from a report released by the World Health Organization (Who) on March 13, 2020 aimed at providing guidelines for the «clinical management of severe acute respiratory infection (Sari) when Covid-19 disease is suspected». The report states (page 1): «Coronavirus disease 2019 (Covid-19) is a respiratory tract infection caused by a newly emergent coronavirus.»

On the other hand, though, it’s important to clarify that thrombosis and problems linked with the circulatory system are today considered as potential complications linked with the new coronavirus. The co-presence of Covid-19 and pulmonary vascular microthrombosis has been confirmed by several studies, but the latter is always intended as a complicating factor rather than as the main problem.

On April 21, Humanitas Clinical Institute – a hospital, university and research center located in Milan, Italy – published an article stating that the association between pneumonia (as generally intended, not necessarily the one caused by coronavirus) and thrombosis has been known for decades, and therefore at Humanitas all Covid-19 patients in intensive care are treated with thromboprophylaxis to reduce the risks. However, Humanitas’ doctors specify, there is no evidence that points at thrombosis as the major and unique cause for admission into intensive care.

The autopsies

Moving on, the viral message goes on stating that the supposed real nature of the new coronavirus has been discovered through a number of autopsies performed in Milan and Bergamo by Italian doctors on 70 deceased patients who tested positive for the new coronavirus.

Media reports confirm that several autopsies have been conducted on Covid-19-related patients at Papa Giovanni XXIII hospital in Bergamo (about 80 autopsies were reported on April 17) and Sacco hospital in Milan, where however the practice was halted on March 30 due to security reasons and in an effort to ease the extreme levels of pressure experienced by healthcare professional in the middle of the pandemic.

The results of the autopsies are not available to the general public. However, the Istituto Superiore di Sanità – a respected public institution linked with the Italian Health Ministry – released on May 22 a report called «Characteristics of SARS-CoV-2 patients dying in Italy.»  The report is based on a sample of 31.096 deceased coronavirus patients, and data are updated to May 21.

The report lists as the most common symptoms that led to hospitalization fever, dyspnoea, and cough. Many of the most common comorbidities observed in patients are related to the circulatory system (ischemic heart disease, atrial fibrillation, heart failure, stroke). These, however, are pre-existing conditions: they are not directly caused by the new coronavirus, since patients already suffered from them.

Anyways, it’s important to specify that when dealing with Sars-CoV-2 the problem of blood coagulation exists, and it has been observed in several patients. The phenomenon is currently being studied and, at the moment, the available data are too limited for providing definitive answers or official health protocols.

The cures

The third claim supported by the viral message suggests that Covid-19, being a thrombosis, can be cured with a mix of anti-inflammatories, antibiotics, and anticoagulants. The different versions of the message propose conflicting advice with regards to which medicines should be used, and some of them do not mention specific drugs. Overall though, they all agree that the right combination would stop the infection in its first stages and thus prevent it from reaching the lungs. It would then be possible to cure the disease at home, making ventilators useless.

Once again, these claims are not supported by the international scientific community. On its official website the Ecdc states that «there is no specific treatment or vaccine for this disease,» a claim supported by the Who and several other institutions, including national governments. A number of drugs is being tested, but at the moment [May 27] they are all considered as «candidate treatments» for Covid-19.

The disease, therefore, is not curable at home, and claiming that ventilators would be useless is again incorrect. Ventilators represent a fundamental ally in the fight against Covid-19, and they have been used worldwide to help patients who couldn’t breathe autonomously.

Conclusion

During the timeframe April-May 2020 a specific fake-news about Covid-19 became viral in Europe and beyond. The message claimed that the new coronavirus would have nothing to do with pneumonia, being instead a thrombosis. Therefore, it can be cured at home with a mix of anti-inflammatories, antibiotics and anticoagulants, making ventilators useless.

The formulation varied slightly across languages and countries, but the main thesis remained unchanged and it always appointed Italy as the country where the discovery was made.

Even though the connection between pneumonia and thrombosis has been known for a long time, and many patients who tested positive for coronavirus developed problems linked with blood coagulation, there is no evidence that points at thrombosis as the main complication of Covid-19. The disease, in facts, remains a «respiratory syndrome».

Furthermore, international organizations and national governments agree in stating that, at the moment [May 27, 2020], there is no specific treatment for Covid-19, and ventilators still represent the main method to help patients breathe when they suffer from lung failure and are unable to do that autonomously: the main problem caused by Covid-19.