A New York study suggests blood thinners may help reduce deaths among critically ill coronavirus patients on ventilators.
In an observational study published in the peer-reviewed Journal of the American College of Cardiology, Mount Sinai doctors gave blood thinners to 28% of 2,773 hospitalized patients with COVID-19, the disease caused by the virus. They discovered the sickest patients benefited the most from the blood thinners.
“The benefit was much more significant in those who were very sick and admitted in the ICU and intubated,” said Dr. Valentín Fuster, senior investigator and corresponding author of the Mount Sinai study.
More than 60% of 234 patients who required mechanical ventilation survived when given blood thinners. Only20% of patients who weren't given blood thinners survived. Doctors, however, say the numbers are subject to change as patients are still hospitalized.
Fuster said the study was a stepping stone to Mount Sinai’s understanding of the role blood thinners can play in coronavirus patients. But he cautioned further validation is needed through more studies.
“This is an opening door on a treatment that could be of great benefit,” he said. “But we are very cautious in interpreting it because it’s an observational study.”
Although there’s still no scientific evidence, anecdotal reports from doctors across the country have suggested an association between the novel coronavirus and blood clotting.
At Mount Sinai, doctors reported five patients under the age of 50 who suffered large vessel strokes over a two-week period, according to a letter published in the New England Journal of Medicine in late April. All five patients tested positive for COVID-19 but had mild to no symptoms.
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“A big part of the way this disease hurts people is in blood clots, whether it’s in the lungs or the kidney or the heart or the brain,” said Dr. J Mocco, director of the Cerebrovascular Center at Mount Sinai.
A study from the Netherlands published in early April looked at 184 patients checked into the intensive care unit for COVID-19 pneumonia. Nearly a third suffered from thrombotic complications, more commonly known as blood clotting.
Although doctors can’t confirm why the symptom occurs, Mocco said research suggests the virus attaches itself to a host cell that exists in the respiratory tract and in blood vessels, allowing the virus to travel anywhere inside the body.
While blood clotting appears to be a prevalent problem among critically ill patients, Mocco said the decision to use blood thinners should be made on a case-by-case basis.
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