International studies led by Canadian researchers suggest that a full dose of blood thinners can help mildly infected COVID-19 patients and keep them away from life support devices.
One of two studies published in New England Journal of Medicine Wednesday shows full-dose blood-thinning heparin results improved and reduced the need for life support for moderately ill COVID-19 patients who were not in intensive care units (ICUs) and did not receive organ support at the start of the trial.
“It is encouraging that we are still finding effective treatments,” said Dr. Patrick Lawler, MD, a physician/scientist at the Peter Monk Heart Center in Toronto and at the University of Toronto. He also co-led the heparin studies.
“Overall, I think this provides a lot of optimism for our ability to resist this terrible pandemic.”
Lawler said the findings could change the way people with moderate symptoms of COVID-19 are treated in Canadian hospitals.
Lawler and an independent expert said the second study shows that more research is still needed on exactly when to give heparin to patients.
The second study found that using full-dose blood thinners on critically ill patients who actually needed life support could actually cause more harm.
“We’ll do some additional studies using our data retrospectively to try to see if there’s a more specific place where the risk-benefit tradeoff is,” Lawler said.
Trials that tested blood thinners were conducted on both groups of patients in nine countries and in more than 300 hospitals, including a portion of the hospitals from the University of Toronto Health Network (UHN).
The trials began in April last year, the trial ended in critical condition in December and the others ended in January of this year.
Lawler said the experimental data included 1,074 critically ill patients and 2,219 moderately ill patients who were given blood thinners for up to 14 days or until they were discharged from the hospital or on supplemental oxygen.
Significant impact
Earlier in the pandemic, it was not known whether blood thinners would be a safe and effective treatment for hospitalized COVID-19 patients.
Investigators turned to blood thinners as a treatment after seeing an increase in the number of blood clots and infections among COVID-19 patients worldwide.
Heparin, which is widely used in Canadian hospitals, is useful in treating COVID-19 because it prevents clots and has an anti-inflammatory effect but may prevent COVID-19 from entering cells, said Dr. Ewan Juliger, who co-led it. Heparin studies.
The results of the two studies are significant, said Dr. Donald Arnold, professor of medicine at McMaster University in Hamilton and a hematologist.
said Arnold, who is also the medical director of the McMaster Laboratory of Platelet Immunology, which has studied rare blood clots associated with COVID-19 vaccines.
“The other attractive part of it is that the intervention is readily available. This is not a fancy treatment that costs a lot of money. This part was really cool to see.”
Arnold said the two studies will stimulate more research as there are still some unknowns regarding the exact time — or what he called the “sweet spot” — of when to give heparin to a patient with moderately ill COVID-19.
“I don’t think we are completely sure and we have to be careful,” he said.
“But this is very convincing evidence that we now have a new treatment for the right patient that may actually benefit them in the long run.”
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