Pittsburgh doctors say coronavirus patients having strokes, blood clots

When Allegheny Health Network doctors studied images of Mark Romutis’ brain, they made an unusual but significant discovery.

The covid-19 disease afflicting Romutis, the interim police chief of Ambridge, had somehow triggered blood clots. The doctors likened them to a traffic jam in the bloodstream.

“It’s as if the Fort Pitt Tunnel shut down,” said Dr. Michael Goldberg, director of Allegheny Health Network’s Division of Neuroradiology.

Romutis, 64, of Conway died April 12. During his hospital stay, he suffered a series of strokes that led to his death. Before he died, doctors did extensive imaging of the blood clots that caused the strokes.

“We were able to show very dramatic imaging of the blood vessels,” Goldberg said. “It’s an important piece of information to share.”

Doctors say the novel coronavirus is prompting strokes in young and middle-aged patients, causing alarm about a disease that’s already been linked to lung damage and failure of other organs. Experts suspect the blood clots and subsequent strokes may be caused by the infection itself or the immune system’s reaction to the virus.

Romutis’ case illustrates a complication believed to happen in about 5% of the most severe covid-19 cases, Goldberg said.

“No one knows for sure why,” he said.

Similar cases are being studied in China and New York City, Goldberg said.

In New York, a team led by Dr. Thomas J. Oxley, from the Department of Neurosurgery at the Mount Sinai Health System, posted case studies Wednesday in the New England Journal of Medicine about strokes in five covid-19 patients who were all younger than 50.

Romutis was older, but his case is important because of the images of the clotting and strokes that doctors were able to document, Goldberg said.

No one can explain why it affects only a small proportion of covid-19 patients, he said.

Romutis had been interim chief in Ambridge since 2018 and previously served as police chief in Ellwood City. He had also worked as a Beaver County sheriff’s deputy and was a retired City of Pittsburgh police officer, where he worked from 1983 through 2004.

Romutis was diagnosed with covid-19 on March 20. His family said he had been recovering before he rapidly declined two days before he died.

Doctors performed scans of Romutis’ brain and the blood vessels in his neck on consecutive days while they treated him for covid-19, Goldberg said, and the images showed the rapid progression of blood clots and their effect.

If there’s any silver lining in her husband’s death, it’s that the images doctors are sharing may help with the treatment of the disease, said Romutis’ widow, Renee.

“There is comfort in that,” Renee Romutis said. “Anything that can help other people.”

Renee Romutis has also tested positive for covid-19. She said she hasn’t experienced any symptoms.

“That’s kind of what scares me,” she said. “I feel good. I have no fever. How many people are walking around like me?”

She warned that the disease can worsen in a matter of hours.

“It’s what happened to my husband,” Renee Romutis said.

The images of the scans of Romutis will be shared with other health professionals in the American Journal of Neuroradiology soon, Goldberg said.