Patients on a therapeutic dose of anticoagulants, or blood thinners, which was defined as a full dose, by the study’s authors, and those on a prophylactic, or lower, doses of the blood-thinning medication had a reduced risk of death by 50% in patients infected with novel coronavirus and decreased need for intubations by 30%, according to the observational study by a team of Mount Sinai researchers in New York that was published in the Journal of the American College of Cardiology.
“Clearly, anticoagulation is associated with improved outcomes and bleeding rates appear to be low,” corresponding author Dr. Anu Lala, an assistant professor of medicine and the director of heart failure research at the Icahn School of Medicine at Mount Sinai, said in a statement. “As a clinician who has treated COVID-19 patients on the front lines, I recognize the importance of having answers as to what the best treatment for these patients entails, and these results will inform the design of clinical trials to ultimately give concrete information.”
The study was developed after it was discovered that many patients infected with coronavirus developed blood clots, according to the researchers. The research team investigated the survival and death rates for patients placed on therapeutic and prophylactic doses of blood thinners, including oral antithrombotics, subcutaneous heparin and intravenous heparin compareed to those not taking anticoagulant medications, according to the researchers.
The researchers analyzed 4,389 medical records of confirmed patients with novel coronavirus in the Mount Sinai Health System in New York City between March 1 and April 30, 2020.
Six different blood-thinning treatments were evaluated within the therapeutic group (full dose) and prophylactic (low dose) groups. The subcutaneous low-molecular weight heparin and therapeutic oral drug apixaban were found to have the most positive outcomes compared to the other drugs. The researchers took into account various factors using a hazard score to estimate risk of death.
The study authors found a strong link between blood thinners and reduced risk of in-hospital deaths in the patients receiving the full dose and prophylactic doses of anticoagulants by nearly 50 percent compared to those who did not take blood thinners. Covid-19 patients on full dose and low doses of therapeutic blood thinners also had fewer intubations compared to the non-prescribed blood thinner group, by 31% and 28%, respectively.
The researchers also looked at bleeding rates, since this is a risk associated with taking anticoagulants, and found them to be “surprisingly low with all patients,” with it occurring in up to 3% of the cases, according to the researchers.
The team of researchers discovered upon autopsy of COVID-19 patients that 11 of 26 patients had blood clots that were not suspected when they were in the clinical setting. They concluded that these findings show treatment with blood thinners may be beneficial in COVID-19 patients to prevent blood clots.
Senior corresponding author Dr. Valentin Fuster told Fox News in an interview that this observational study has laid down the foundation for a larger global clinical trial that the research team is coordinating.
The clinical trial will be “focusing on the three antithrombotic regimens: therapeutic and prophylactic subcutaneous low-molecular-weight heparin, and therapeutic oral apixaban,” Fuster, also the director of Mount Sinai Heart and physician-in-chief of the Mount Sinai Hospital, said in a statement included with the release.
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