COVID-19: Full-Dose Blood Thinners May Reduce Organ Support Necessity for Moderately Ill Patients

A large-scale worldwide clinical trial has shown that treating hospitalized moderately ill COVID-19 patients with full-dose blood thinners significantly reduced the need for organ support like mechanical ventilation and increased the patient's chances of leaving the hospital.

Unfortunately, the same outcome was not observed in patients with severe COVID-19 requiring ICU care.

What are Blood Thinners?

Blood thinners, according to Medline Plus, are medicines that prevent the formation of blood clots. These also help reduce the chances of existing blood clots increasing in size. Blood clots in a person's heart, veins, and arteries can cause numerous adverse health effects such as strokes, heart attacks, and other blockages.

Commonly, those diagnosed with certain blood vessel and heart diseases, atrial fibrillation, heart valve replacements, high risk for clots post-op, and congenital heart defects regularly take blood thinners.

The two main blood thinner types used are anticoagulants like warfarin and heparin that slows down the body's making clots, and antiplatelet drugs like aspirin prevent blood cells from clumping together and forming blood clots.

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Full-Dose Blood Thinners Reduce the Need for Mechanical Ventilators in Moderately Ill COVID-19 Patients, But Not For Severe ICU-Supported Patients

The findings in two studies published in The New England Journal of Medicine, entitled "Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19" and "Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19," studied both moderately ill and critically ill COVID-19 patients.

Incorporating data from 3 platform trials are part of a worldwide collaborative effort to identify possible treatments for COVID patients during the height of the pandemic. The research led by NYU Grossman School of Medicine and the University of Pittsburgh, together with global collaborators, launched ACTIV4a. Researchers observed how patients who died from COVID-19 had blood clots throughout the body, including the smallest blood vessels.

Researchers saw antithrombotics, blood thinners, or anticoagulants as a plausible treatment option because they significantly reduce clotting risks. However, the field was unsure whether to use a full therapeutic dose to treat blood clots or to opt for a lower dosage used in clot prevention.

Gary Gibbons, M.D, NHLBI Directory, says that the study results are compelling examples showcasing the importance of stratifying patients with different severity in clinical trials NIH reports.

Researchers defined moderately ill COVID-19 patients as those hospitalized without organ support, while critically ill patients require ICU-level support, including cardiovascular organ support and respiratory support.

In moderately ill COVID-19 patients, study authors observed that there was a 99% chance that full-dose blood thinners like heparin increased the patient's chances of survival and hospital discharge with a significantly reduced need for organ support like mechanical ventilation compared to those that were receiving low doses of heparin NYU Langone Health reports.

However, a small percentage of patients included in the trials experienced major bleeding, but researchers say this was a rare occurrence.

On the other hand, critically ill patients on full dose-heparin also had decreased numbers of major thrombotic events; however, they did not have the same results as moderately ill patients.