Giving blood thinners to COVID-19 patients soon after they’re hospitalized could reduce their risk of dying.
That’s the conclusion of a new large observational study published in BMJ by researchers from the US Department of Veterans Affairs, Vanderbilt University Medical Center, University of Pittsburgh, Yale School of Medicine, Yale School of Public Health, and the London School of Hygiene & Tropical Medicine. They looked at the electronic health records of 4,297 patients hospitalized with COVID-19 from March 1 to July 31, 2020.
Because coronavirus-related blood clots that develop in major arteries and veins can lead to death, the researchers aimed to see if anticoagulants, which have antiviral, and possibly anti-inflammatory, effects, could prevent coagulation.
Of the 3,627 (84.4%) who received prophylactic anticoagulants (subcutaneous heparin or enoxaparin) on their first day in the hospital, 14.3% died within 30 days, compared with 18.7% of those who didn’t receive the drugs (relative risk reduction [RR], 34%; absolute RR, 4.4%).
Patients who received anticoagulants had a 27% lower risk of death within 30 days than those who didn’t receive them (hazard ratio [HR], 0.73). Similar associations were identified for inpatient death.
The anticoagulant benefit appeared to be greatest among patients not requiring intensive care unit admission within 24 hours of hospitalization. Anticoagulant use was not linked to an increased risk of serious bleeding requiring transfusion (HR, 0.87). Of the 4,297 patients, 93% were men; the average age was 68 years.
Researchers noted that while previous studies had found evidence of the effectiveness of anticoagulants in coronavirus patients, they had small sample sizes or were conducted in relatively small healthcare systems.
The latest study provides strong real world evidence to support guidelines recommending the use of prophylactic anticoagulation as initial treatment for patients with COVID-19 on hospital admission. Clinical trials are being conducted to determine whether anticoagulants could be an effective treatment for coronavirus. The World Health Organization (WHO) now suggests the use of low-dose anticoagulants for preventing the blood clots forming in blood vessels (thrombosis).
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Dr. Melvin Sanicas (@Vaccinologist) is a physician-scientist specializing in vaccines, infectious diseases, and global health.