How Luke Letlow's COVID-19 case likely led to a heart attack and his death

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Former Louisiana governor on death of Luke Letlow: 'He would've been a great leader for our country'

Former Louisiana Gov. Bobby Jindal reflects on his friendship with Congressman-elect Luke Letlow, who died this week from complications due to coronavirus.

Louisiana Republican Rep.-elect Luke Letlow died last week of COVID-19 complications related to a blood clot and heart attack, according to the chancellor of the hospital where Letlow had been treated.

Letlow, 41, experienced the heart attack last week following a medical procedure at LSU Health Shreveport to remove a blood clot caused by the virus.

"Congressman-elect Luke Letlow ultimately died from complications of COVID-19. His immediate death due to a heart attack is likely related to thromboembolic phenomena caused by COVID-19," Dr. G. E. Ghali, chancellor of Shreveport, told Fox News in a statement.

Thromboembolism is the formation of a blood clot that can travel through veins to other parts of the body, potentially plugging vessels within the limbs, lungs, and even the brain, which can cause heart attacks or strokes. 

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"COVID-19 thickens blood, and that is a risk for heart attacks," Dr. Adrian Messerli, director of Cardiac Catheterization Laboratories at University of Kentucky Health Care, told Fox News. "The clotting disorder related to COVID is something we're very familiar with."

Luke Letlow, chief of staff to exiting U.S. Rep. Ralph Abraham, speaks after signing up to run for Louisiana's 5th Congressional District in Baton Rouge, La.  (AP Photo/Melinda Deslatte, File)

If there is a compromise to the lungs and patients have trouble breathing as a result, doctors may try to "extract some of the blood clot from the lung," Messerli said, which may be a reason Letlow underwent a procedure, though it is unknown exactly what procedure doctors performed on the late congressman-elect. Shreveport did not share further details.

Dr. Tom Maddox, a practicing cardiologist and professor of cardiology at the Washington University School of Medicine, said that "in extreme cases," doctors can do "clot removal if it's creating life-threatening blockage of a particular organ" such as the lungs or a limb.

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Both cardiologists, who are not directly familiar with Letlow's death but are experts in the field and who have studied how COVID-19 can impact the heart, said clotting can be quite common in COVID-19 patients because the disease causes inflammation, which thickens the blood.

COVID-19 "generates a lot of inflammatory proteins and substances in the blood," Maddox said. The primary job of the blood is to activate white blood cells to fight off an infection, so when inflammation occurs as a result of COVID-19, "it can increase the...relative thickness of the blood," which may then result in blood clot formation and other issues.

Many COVID-19 patients are treated with prophylactic doses of blood thinners, which Maddox said is still "an active area of investigation."

Blood clot (Credit: iStock)

Because blood clots that lead to heart attacks are rare for young people who appear to have no underlying medical conditions, the reason Letlow suffered a heart attack is a direct result of "COVID-19 infection," Messerli said.

Maddox explained that the procedure of mechanically removing a blood clot from a COVID-19 patient is "far less than 1%," and depending on patients' underlying health conditions, Letlow's personal risk of dying as a result of experiencing a heart attack "even in a procedure" and in "the setting of a big infection like COVID would also be less than 1%."

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"It sounds like he was just very unlucky in experiencing all that in the course of his illness," the professor said. He added later that "it's rare, obviously, for somebody like [Letlow] to die, but it happens, and that's why we're just so maniacal about wearing masks, distancing -- all the stuff we always beat the drum on."

Messerli suspected that Letlow likely suffered a large heart attack and doctors were unable to resuscitate him.

"There are obviously smaller heart attacks, and then there are larger heart attacks, and that has to do with what part of the heart artery anatomy the heart attack occurs within," he said. "So, if you have a very severe heart attack that accounts for multiple arteries...the mortality rate for something like that is much higher than a more minor heart attack."

Shreveport Chancellor G.E. Ghali told the Monroe News-Star that Letlow had no underlying conditions.

"It's devastating to our entire team," Ghali told the outlet, adding that Letlow had no underlying conditions. "It was just COVID."

Maddox wondered whether the stress of Letlow's COVID-19 infection on top of "any medical procedure" he may have undergone "together resulted in a heart attack."

Both doctors expressed sympathy for Letlow's family and for the medical providers who treated his illness.

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"It's a most horrific trauma for the families involved...but it's also very traumatic for the care providers because these are not folks we're accustomed to having pass away," Messerli said. "So, to take care of a young man like this that's about to embark on a congressional career and having passed away because of this disease is tremendously emotionally traumatic."

Maddox said there is still so much that experts do not know about the new virus that has taken more than 350,000 lives in the U.S. alone.

"Why it sometimes just rages like wildfire in young folks we don't know yet," he said. "There has been some speculation that some people may be predisposed. When they get an infection, their immune system really kind of goes crazy and almost overshoots what is needed to fight the infection."

"Why that would be, there's not a strong theory yet. We don't understand that very well, and maybe it's somebody's genetic predisposition or other things," he continued. "...There's not a reliable way to know who would potentially have that response versus who wouldn't, which is why the best strategy right now is to say everybody needs to take as much precaution as possible."

Eight out of every 10 COVID-19 deaths in the United States have been in adults ages 65 or older, according to the Centers for Disease Control and Prevention.

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Adults between the ages of 40 and 49 are three times more likely to be hospitalized and 10 times more likely to die from the virus than a comparison group of adults between the ages of 18 and 29.

One July study published in MedRxiv found that the infection fatality rate (IFR) increased from 0.01% among 25-year-old adults to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75 and 15% at age 85. Certain underlying medical conditions, however, can worsen COVID-19 cases.

It remains unclear why some young, healthy individuals experience severe symptoms and, occassionally, death. Experts have suggested that a healthy person's genetic makeup may play into how individual bodies respond to the virus.