{"id":774,"date":"2020-05-08T10:44:36","date_gmt":"2020-05-08T05:14:36","guid":{"rendered":"http:\/\/www.potentialloops.org\/?p=774"},"modified":"2020-05-08T10:44:38","modified_gmt":"2020-05-08T05:14:38","slug":"blood-thinners-may-improve-survival-among-hospitalized-covid-19-patients","status":"publish","type":"post","link":"https:\/\/www.potentialloops.org\/?p=774","title":{"rendered":"Blood thinners may improve survival among hospitalized COVID-19 patients"},"content":{"rendered":"\n

Research could change standard of care protocols to prevent clotting associated with coronavirus <\/h4>\n\n\n\n

Date: May 7, 2020 <\/p>\n\n\n\n

Source 1: The Mount Sinai Hospital \/ Mount Sinai School of Medicine <\/p>\n\n\n\n

Source 2: www.sciencedaily.com<\/a><\/p>\n\n\n\n

Summary: Treating hospitalized COVID-19 patients with anticoagulants — blood thinners that slow down clotting — may improve their chances of survival, researchers report. The study could provide new insight on how to treat and manage coronavirus patients once they are admitted to the hospital. <\/p>\n\n\n\n

Treating hospitalized COVID-19 patients with \nanticoagulants — blood thinners that slow down clotting — may improve \ntheir chances of survival, researchers from the Mount Sinai COVID \nInformatics Center report. The study, published in the May 6 issue of \nthe Journal of the American College of Cardiology<\/em>, could provide new insight on how to treat and manage coronavirus patients once they are admitted to the hospital.<\/p>\n\n\n\n

The study found that hospitalized COVID-19 patients treated with \nanticoagulants had improved outcomes both in and out of the intensive \ncare unit setting. The research also showed that the difference in \nbleeding events among patients treated with and without anticoagulants \nwas not significant. The Mount Sinai researchers say their work outlines\n an important therapeutic pathway for COVID-19 patients.<\/p>\n\n\n\n

“This research demonstrates anticoagulants taken orally, \nsubcutaneously, or intravenously may play a major role in caring for \nCOVID-19 patients, and these may prevent possible deadly events \nassociated with coronavirus, including heart attack, stroke, and \npulmonary embolism,” says senior corresponding author Valentin Fuster, \nMD, PhD, Director of Mount Sinai Heart (the nation’s number six ranked \nhospital in Cardiology\/Heart Surgery) and Physician-in-Chief of The \nMount Sinai Hospital. “Using anticoagulants should be considered when \npatients get admitted to the ER and have tested positive for COVID-19 to\n possibly improve outcomes. However, each case should be evaluated an \nindividualized basis to account for potential bleeding risk.”<\/p>\n\n\n\n

The publication of this study follows recent research out of the \nIcahn School of Medicine at Mount Sinai that shows a large number of \npatients hospitalized with COVID-19 have developed high levels of \nlife-threatening blood clots, leading to potentially deadly \nthromboembolic events.<\/p>\n\n\n\n

A team of investigators evaluated records of 2,773 confirmed \nCOVID-19-positive patients admitted to five hospitals in the Mount Sinai\n Health System in New York City (The Mount Sinai Hospital, Mount Sinai \nWest, Mount Sinai Morningside, Mount Sinai Queens, and Mount Sinai \nBrooklyn) between March 14 and April 11, 2020. They specifically looked \nat survival rates for patients placed on blood thinners versus those not\n placed on blood thinners. The researchers took certain risk factors \ninto account before evaluating the effectiveness of anticoagulation, \nincluding age, ethnicity, pre-existing conditions, and those already on \nblood thinners.<\/p>\n\n\n\n

Of the COVID-19 patients analyzed, 786 (28 percent) received a \nfull-treatment dose of anticoagulants — a higher dose than what is \ntypically given for blood clot prevention, and one that is usually given\n to those who already have clots or are suspected to have clots. \nTreatment with anticoagulants was associated with improved hospital \nsurvival among COVID-19 patients both in and out of the intensive care \nunit setting. Of the patients who did not survive, those on \nanticoagulants died after spending an average of 21 days in the \nhospital, compared to the non- anticoagulant patients who died after an \naverage of 14 days in the hospital. The effect of anticoagulation had a \nmore pronounced effect on ventilated patients — 62.7 percent of \nintubated patients who were not treated with anticoagulants died, \ncompared to 29.1 percent for intubated patients treated with \nanticoagulants. Of the intubated patients who did not survive, those \nwith no anticoagulants died after 9 days, while those on anticoagulants \ndied after 21 days.<\/p>\n\n\n\n

All patients in the study had blood work done when they arrived at \nthe hospital, which included measuring various inflammatory markers. The\n analysis of their records showed patients who received anticoagulants \nhad higher inflammatory markers compared to patients not treated with \nanticoagulants. This may suggest patients with more severe illness may \nbenefit from anticoagulants early on.<\/p>\n\n\n\n

The observational study also explored the association of systemic \nanticoagulant treatment with bleeding events. Major bleeding was defined\n as 1) hemoglobin <7 g\/dL and any red blood cell transfusion; 2) at \nleast 2 units of red blood cell transfusion within 48 hours; or 3) a \ndiagnosis code for major bleeding including intracranial hemorrhage; \nhematemesis; melena; peptic ulcer with hemorrhage; colon, rectal, or \nanal hemorrhage; hematuria; ocular hemorrhage; and acute hemorrhagic \ngastritis. Among those who did not receive anticoagulants, 38 (1.9 \npercent) patients had bleeding events, compared to 24 (3 percent) among \nthose who received anticoagulants, p=0.2).<\/p>\n\n\n\n

“We are hopeful that this report of the association of \nanticoagulation therapy with improved survival will be confirmed in \nfuture investigations. The astute scientists at Mount Sinai continue to \nanalyze our data on COVID-19 patients in order to contribute to \nworldwide efforts to find effective treatments,” says David Reich, MD, \nPresident and Chief Operating Officer of The Mount Sinai Hospital.<\/p>\n\n\n\n

“As a cardiologist who has been on service caring for COVID-19 \npatients for the last three weeks, I have observed an increased amount \nof blood clot cases among hospitalized patients, so it is critical to \nlook at whether anticoagulants provide benefits for them,” says \nco-researcher Anu Lala, MD, Assistant Professor of Medicine (Cardiology)\n at the Icahn School of Medicine at Mount Sinai. “It’s important to note\n that further analysis and prospective studies are required to determine\n the effectiveness for widespread use of anticoagulants in hospitalized \nCOVID-19 patients.”<\/p>\n\n\n\n

“This study is opening the door for a more extensive study that will \nbe carried out with 5,000 COVID-19-positive patients, where we will \nevaluate the effectiveness of three types of antithrombotic therapy — \noral antithrombotic, subcutaneous heparin, and intravenous heparin — \nand then perhaps engage our data for prospective clinical trials,” says \nsenior author Girish Nadkarni, MD, Co-Director of the Mount Sinai COVID \nInformatics Center. “We are excited about these preliminary results that\n may have a positive impact on COVID-19 patients and potentially give \nthem a greater chance of survival, although more studies are needed.”<\/p>\n\n\n\n

\n\n\n\n

Story Source:<\/strong><\/p>\n\n\n\n

Materials<\/a> provided by The Mount Sinai Hospital \/ Mount Sinai School of Medicine<\/strong><\/a>. Note: Content may be edited for style and length.<\/em><\/p>\n\n\n\n

www.sciencedaily.com<\/a><\/p>\n\n\n\n

\n\n\n\n

Journal Reference<\/strong>:<\/p>\n\n\n\n

  1. Ishan Paranjpe, Valentin Fuster, Anuradha Lala, Adam Russak, \nBenjamin S. Glicksberg, Matthew A. Levin, Alexander W. Charney, Jagat \nNarula, Zahi A. Fayad, Emilia Bagiella, Shan Zhao, Girish N. Nadkarni. Association of Treatment Dose Anticoagulation with In-Hospital Survival Among Hospitalized Patients with COVID-19<\/strong>. Journal of the American College of Cardiology<\/em>, 2020; DOI: 10.1016\/j.jacc.2020.05.001<\/a>\n<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

    Research could change standard of care protocols to prevent clotting associated with coronavirus Date: May 7, 2020 Source 1: The Mount Sinai Hospital \/ Mount Sinai School of Medicine Source 2: www.sciencedaily.com Summary: Treating hospitalized COVID-19 patients with anticoagulants — blood thinners that slow down clotting — may improve their chances of survival, researchers report. 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