While most people who get infected with COVID-19 recover at home, doctors say it's hard to predict who will succumb to severe disease.
48-year-old Alfred Gabriel of Chino Hills had been on life support for nearly two weeks due to a COVID-19 infection. When he was taken off the ventilator, Gabriel felt a bit dazed, but he knows just how lucky he is considering just two weeks ago, he went to the hospital gasping for air.
"COVID was just so severe in him," said Dr. Laren Tan, a pulmonologist at Loma Linda University Health. So why do only some patients like Alfred get this sick?
"It looks very much as though what's happening is that the clots are forming and are just too small to be seen," said Dr. Brian Bull, a pathologist with Loma Linda University.
Bull and his colleagues discovered when COVID-19 invades, agents of the body's immune system, macrophages, eat virus-infected cells in the lung which ultimately puncture small blood vessels. This slow-clotting process consumes the protein fibrinogen leading to "micro-clots."
"Normally we have a little bit of it in our circulation, but in COVID it just goes sky high," said Bull.
The micro-clots go on to kill small patches of tissue in the lungs, the heart and other organs.
Bull says being able to identify this micro-clotting process can help patients like Alfred get treatment early and avoid the hospital. But doctors say the best way to prevent all this is to get the vaccine which is going to decrease the number of cells that would become infected.
"Don't gamble on your life because at this point we don't know who is going to get a severe illness and who's actually going to make it out alive," Tan said.
Working from home, Gabriel didn't think he would get exposed so he took his time making a vaccine appointment. As it turns out, he tested positive for COVID-19 the week he was scheduled to get vaccinated. He regrets waiting.
"Being here now for as long as I have compared to a 5-minute vaccination. It's not worth it," Gabriel said.