Covid-19: Anticoagulants increase the chance of survival

Florian Tiefenböck studied human medicine at the LMU Munich. In March 2014, he joined as a student and has supported the editorial team with medical articles ever since. After receiving his medical license and practical work in internal medicine at the University Hospital Augsburg, he has been a permanent member of the team since December 2019 and, among other things, ensures the medical quality of the tools.

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It is already known that anticoagulants can help Covid-19 patients. Now, according to a large-scale study in the "Journal of the American College of Cardiology", US doctors report that even the precautionary administration of drugs significantly lowers the risk of death - and also prevents other problems.

For the study, the researchers analyzed patient data from March and April from five hospitals in the Mount Sinai Group in New York. They divided the total of 4,389 Covid 19 patients into three groups: One group received no anticoagulants, the second received such preparations for treatment. The third group was given a lower dose as a precautionary measure. Heparin and low molecular weight heparin as well as tablets with the active ingredient apixaban were used subcutaneously via the vein or under the skin.

Risk of death up to 50 percent lower

Almost 29 percent of those patients who had been treated therapeutically with "blood thinners" died. In the group that received no such drugs, it was just under 26 percent. That picture changed, however, after the researchers considered the participants' pre-existing conditions and other health factors that can also affect the risk of death.

The result: The risk of death was 47 percent lower in patients who had been treated therapeutically, i.e. in full dose, with an anticoagulant. In the group that received the medication at a lower, precautionary dose, the risk was reduced by 50 percent. Treatment with “blood thinners” - taking into account the patient's condition - was associated with a death rate that was roughly halved.

Also useful for ventilation

In addition, the risk of having to be artificially ventilated fell in those two groups who received the anticoagulants - by 31 percent for those treated therapeutically and by 28 percent for those treated as a precaution. Serious complications from bleeding, such as the one that can encourage the use of anticoagulants, occurred in three percent of those treated therapeutically. In the other two groups, the proportion was less than two percent.

Risk of blood clots

Additional indications that “blood thinners” can be useful for Covid-19 patients were obtained from 26 autopsies of people who had died of Covid-19. In 11 of them, the doctors found evidence of thrombosis - caused by blood clots, which treatment with anticoagulants could probably have prevented. A life-threatening pulmonary embolism can also develop on the basis of such thromboses.

“With the exception of a stroke, there was no suspicion of thromboembolic disease prior to the autopsy. This suggests that clinical assessments may underestimate the actual exposure to thromboembolic disease, ”the researchers write. A few months ago there were already increasing reports of the risk that Covid 19 patients could suffer fatal complications from blood clots (houseofgoldhealthproducts.de reported).

Anticoagulant treatment recommended

For Uwe Janssens, President of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) in Berlin, the result is no surprise: "It has long been known in clinics that thromboembolic events are a frequent complication of Covid-19." Treatment recommendations had already been published in June in a guideline of numerous specialist societies for intensive medical therapy of Covid-19 patients. You can find out more about the treatment of Covid-19 here.

Nevertheless, Janssens praises the large amounts of data in the current study. When admitting Covid 19 patients to hospital, it is very important to take a close look at many aspects of their condition. In further studies, the US researchers now want to determine, among other things, the best possible substance, dose and duration of anticoagulant therapy for Covid-19. The study is also intended to be the basis of a number of international studies. (ft / dpa)

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