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Newswise – While COVID-19 infected patients should be treated with standard anticoagulant therapies, such as blood-thinning medications, a new study by George Washington University (GW) researchers shows that anticoagulant patients at higher doses, without the traditional medical indications for doing so can be ineffective and even harmful. The study was published in the journal Thrombosis Research.
“COVID-19 patients appear to have a higher incidence of blood clots. Many hospitals and healthcare professionals have started using high doses of anticoagulants to prevent these clots or treat them preventively, “said Juan Reyes, MD, MPH, study co-author and director of hospital medicine at the GW School of Medicine and Health Sciences ( SMHS). “We wanted to review data from our subset of COVID-19 patients treated with anticoagulants to determine if the higher dose drug was useful.”
“While it is true that COVID-19 patients could die from blood clots, the data we evaluated do not support each patient being given a high dose of anticoagulants. This is a challenge, as the benefits still remain unclear, “said Lei Lynn, MD, first author of the study and assistant professor of medicine at GW SMHS.” We caution against an aggressive anticoagulant regimen for all, unless there is clear evidence to do so. ”
At the start of the pandemic, all patients admitted with COVID-19 to GW Hospital were treated with a standard anticoagulant dose, unless contraindicated. As awareness of the high risk of blood clots developed, many providers began treating patients with high-dose anticoagulants. At GW Hospital, for non-critically ill patients, medical teams have been advised to particularly consider starting a high dose of anticoagulant if a patient’s D-dimer level exceeds 3 micrograms per milliliter. The research team previously published a study that found that higher levels of the biomarker D-dimer, a medical marker found in the blood, are associated with a higher chance of clinical deterioration and death from COVID-19. This study is the first of its kind to use D-dimer levels to analyze the clinical results of anticoagulation in patients who are not in critical condition.
“While we would have liked to see a clinical benefit for our patients from anticoagulation, our research found that higher doses of blood thinners were potentially harmful, with no clear benefits,” said Karolyn Teufel, MD, co-author of the study and assistant professor of medicine at GW SMHS. “Our research highlights the challenges with COVID-19 treatment. So many things remain unknown. ”
In addition to Reyes, Ayanian, Lynn, and Teufel, the research team included Katrina Hawkins, MD; Arjun Panda, MS; Laura Linville, MD; Walaa Aldhahri, MD; Ghazal Kango, MD; Sneha Shah, MD.
“The effect of anticoagulation on clinical outcomes in novel Coronavirus pneumonia (COVID-19) in a US cohort” was published in Thrombosis Research.
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