Wouldnt there be a marked prevalence of cold hands/feet in me/cfs patients if there were micro clots going on?
I think the idea is that the micro-clots are taking effect at the capillary level (reducing oxygen diffusion to tissues) and at the red-cell level (impairing their deformability and transit through capillaries). This is all theoretical currently. The micro-clots aren't occluding larger vessels, sufficient to cause eg limb ischaemia.
You might get cold peripheries at times though, related to the POTS changes which I suspect are failed compensations for the micro-circulation issues.
And dont you think the micro clots would sometimes lump together forming clots in e.g the head or lungs, so that me/cfs patients would have a marked prevalence of hospitalization because of these conditions?
At this time we don't know that micro-clots are the problem in ME (but the symptom overlap is so striking, that it has to be related). There's obviously something very special about the micro-clots — they've only recently been appreciated, so presumably tend not to cause clinically obvious DVT, stroke etc.
One possibility is that they are present in the early phase of the disease, i.e. the earliest long Covid is only just over 18 months. Perhaps they clear but persistent / late-phase ME is because of long-standing effects on the micro-circulation. (I was wondering about induced short capillary AV shunts for example.)
Much yet to learn, but this seems incredibly promising to me. I hope we are able to show micro-clots in ME. One way to almost immediately answer the question is if the nano-needle technique gave a positive result without the monocytes in the sample. Then we'd be pretty confident that the long term ME patients they were testing (with high specificity) were due to micro-clots (the "something in the blood").