Daily Bulletin

News

  • Written by Karlheinz Peter, Lab Head, Atherothrombosis and Vascular Biology and Deputy Director, Baker Heart and Diabetes Institute; Interventional Cardiologist, Alfred Hospital; Professor of Medicine and Immunology, Monash University, Baker Heart and Diabetes Insti

A spate of recent media headlines have described blood thinning medications – which include aspirin and warfarin – as a “breakthrough treatment” for COVID-19 that could “save lives”.

It’s early days yet but a growing body of research evidence suggests COVID-19 causes abnormalities in blood clotting, which means blood thinning drugs may have a role to play in treatment.

Here’s what the research says on this question – and how it applies to you.

Mounting evidence

When COVID-19 first emerged, it was thought the illness was a typical respiratory disease causing symptoms such as fever, sore throat, dry cough, and potentially lung infection (pneumonia) and a build-up of fluid in the lungs making it difficult to breathe.

However, as we outlined in a previous article in The Conversation, 30-70% of COVID-19 patients admitted to intensive care units, developed blood clots.

These rates of blood clotting appear to be much higher than what is expected when compared with people who are hospitalised for reasons other than COVID-19.

Blood clots in the veins often present in the legs (deep vein thrombosis) and are dislodged into the lungs (called pulmonary embolism); approximately one in four COVID-19 patients admitted to intensive care will develop a pulmonary embolism (where an artery in the lungs gets blocked).

Arterial blood clots associated with COVID-19 can lead to strokes, including in younger patients, with potentially devastating outcomes.

In addition, COVID-19 appears to cause tiny blood clots that can block small vessels in the lungs. These “micro” blood clots may be a key reason why patients with COVID-19 often have very low oxygen levels.

Blood clots appear to be associated with a higher risk of dying from COVID-19. Likewise, elevated markers of blood clotting are associated with an increased risk of admission to the intensive care unit and a worse prognosis overall.

Could blood thinners be a lifesaving treatment for COVID-19? Here's what the science says and what it means for you AAP Graphics/Sean Fitzpatrick Should blood thinners be standard treatment for COVID-19 patients in hospital? Because the rate of blood clotting is so high, all people admitted to hospital with COVID-19 should receive a low dose of blood thinner medication to prevent blood clots. This prophylactic dose of blood thinner is standard across most hospitals in Australia. However, many blood clots in COVID-19 are occurring despite the use of low-dose blood thinners. As such, it is a question of intense discussion whether people admitted to hospital with severe COVID-19 should receive a higher-than-usual dose of blood thinners to prevent blood clots and improve clinical outcomes. A recent study from the US suggests patients admitted to hospital and prescribed full dose blood thinners had a better chance of survival and lower chance of needing a ventilator. However, this finding has to be confirmed before the higher dose can be generally recommended. Fortunately, several research studies are underway in Europe, the UK and elsewhere to test and answer this question definitively. Several other blood thinner treatments are also being evaluated in people with COVID-19. Aspirin is commonly prescribed to people who are at high risk of strokes or heart attacks. There are now studies underway examining if aspirin can reduce risk of blood clotting in people with COVID-19. In the US, some stronger clot-busting medications are also being trialled in people with severe COVID-19. It is important to note blood thinners are not without risk, as this treatment can increase the risk of bleeding. So without definite evidence to support the benefit of high dose blood thinners in all hospitalised patients with COVID-19, the decision to use higher doses of blood thinning medication outside of a clinical trial must be made on an individual basis. Could blood thinners be a lifesaving treatment for COVID-19? Here's what the science says and what it means for you The Conversation, CC BY-ND Should I take an aspirin to prevent blood clots? There is no evidence aspirin or other blood thinners should be taken to prevent blood clots in the general population. Also, there is no evidence blood thinners are required to prevent blood clots for people with mild COVID-19 who are isolating at home. Because blood thinners can cause bleeding, they should not be taken unless prescribed by a doctor. It is important for people who are taking blood thinners for another reason to continue taking these medications as normal, particularly if they are diagnosed with COVID-19. In summary, our understanding of COVID-19 and how the coronavirus attacks the body continues to rapidly evolve. Researchers from around the world are publishing data almost daily. However, not all of this research has been peer reviewed. If you develop symptoms, the most important thing you can do is to get tested for COVID-19 and talk to your doctor about potential treatments, including hospital admission and then about blood thinning medication. Similar to our colleagues in the UK and the US, we as doctors specialised in the field of blood clotting are indeed optimistic and hope clinical studies currently underway will show rigorous strategies for prevention and treatment of blood clotting will help to reduce severity and improve survival of patients with COVID-19. Read more: Coronavirus: how long does it take to get sick? How infectious is it? Will you always have a fever? COVID-19 basics explained

Authors: Karlheinz Peter, Lab Head, Atherothrombosis and Vascular Biology and Deputy Director, Baker Heart and Diabetes Institute; Interventional Cardiologist, Alfred Hospital; Professor of Medicine and Immunology, Monash University, Baker Heart and Diabetes Institute

Read more https://theconversation.com/could-blood-thinners-be-a-lifesaving-treatment-for-covid-19-heres-what-the-science-says-and-what-it-means-for-you-138813

Writers Wanted

The Mitchells vs The Machines shows 'smart' tech might be less of a threat to family bonds than we fear

arrow_forward

The Essentials of DIY Home Repairs: What You'll Need

arrow_forward

The Conversation
INTERWEBS DIGITAL AGENCY

Politics

Prime Minister interview with Karl Stefanovic and Allison Langdon

Karl Stefanovic: PM, good morning to you. Do you have blood on your hands?   PRIME MINISTER: No, it's obviously absurd. What we're doing here is we've got a temporary pause in place because we'v...

Karl Stefanovic and Allison Langdon - avatar Karl Stefanovic and Allison Langdon

Prime Minister Scott Morrison delivered Keynote Address at AFR Business Summit

Well, thank you all for the opportunity to come and be with you here today. Can I also acknowledge the Gadigal people, the Eora Nation, the elders past and present and future. Can I also acknowled...

Scott Morrison - avatar Scott Morrison

Morrison Government commits record $9B to social security safety net

The Morrison Government is enhancing our social security safety net by increasing support for unemployed Australians while strengthening their obligations to search for work.   From March the ...

Scott Morrison - avatar Scott Morrison

Business News

The logistics behind setting up massive vaccination hubs in South Australia

To scale up the South Australian vaccination rollout, Portable Partitions Australia were approached by SA Health to urgently provide 78 vaccinations booths across the Northern and Central mass vac...

NewsCo - avatar NewsCo

The Age Of Advertising: The Importance of Online Business Advertisements

The language of advertising had long grown since its modern beginning in the 15th century when printing was all the jazz. Nowadays, it continues to flourish and adapt as new mediums are created, a...

NewsCo - avatar NewsCo

What is Hampering Your Good Sleep? 7 Things to Check

A good sleep is the pillar of a healthy body and a strong mind. Countless studies have proven how a good night’s sleep goes hand in hand with good health and a productive day ahead. Sleep has an i...

NewsCo - avatar NewsCo