And patients who received anticoagulants were also 30% less likely to need a ventilator to breathe, a team at the Mount Sinai Health System in New York reported.
Their study of more than 4,300 patients, including those who died, often had evidence of blood problems in their bodies, although many of them had no symptoms of the problem. There is more evidence of serious, systemic blood clotting that can cause coronavirus infections, but the findings offer hope to counteract the effect.
It was not a randomized controlled trial, the gold standard for medical research. The leader of the study, Dr. Valentin Fuster, says it’s the following. “An international randomized trial just began with 15 institutions,” Fuster told CNN. “We compare three types of anticoagulants that work.”
Fuster’s team said 60% of patients who did not receive anticoagulants were discharged alive, 26% of them died in hospital and 13% were still in hospital.
When patients received the drug prophylactically to prevent blood clots, 75% were released alive, 22% died in the hospital and 3% remained in the hospital during the study period. The researchers said the reduction in the risk of death was similar in patients who received anticoagulants to prevent clotting, or after they began to show clotting.
Sal Mazzara is one of the survivors. He was hospitalized in early April because his coronavirus infection diminished and remained in a ventilator for a month.
“Sal did not have blood clots, but he was given blood clots every day to prevent them,” his wife, Josephine Mazzara, told CNN. Initially, Mazarra received the blood-throbbing drug tPA, used for emergency treatment of a stroke. He later received heparin and was sent home with Eliquis, commonly known as apixaban – a pill approved to prevent stroke.
Mazzara’s treatment required heavy sedation and a cut in his throat so he could be intubated. “It was a horrible, horrible experience,” Josephine Mazzara said.
“I can not remember much,” Sal Mazzara, 48, told CNN. “I’m completely black.”
The only specific treatment for coronavirus is the antiviral drug remdesivir. Mazzara received that medicine as well, during his treatment, Josephine Mazzara said.
Doctors have also learned that steroids, specifically dexamethasone, can also help patients recover better from coronavirus infections. Trials are underway to test blood-based therapies that deliver different types of antibodies to help patients fight the infection, using plasma donated by people who have recovered from infections.
In the absence of a slam-dunk treatment for the virus, many medical teams take a cocktail approach, giving their patients a combination of medications to control the immune response, control the virus, and control blood clotting.
Mazzara remained a blood donor for a month after his release in hospital in May. “I’m like 90% back,” he said.
Shortly after the New York City pandemic hit hard in March, doctors began to notice that their patients were suffering from systemic blood clotting. Blood clots clog kidneys for kidney dialysis and damage patients’ lungs, livers and hearts.
Doctors now believe that the inflammation caused by coronavirus infection causes the clotting. Sometimes it does not cause symptoms until it is too late.
In the Mt. Sinai study, autopsies on some of the patients who died, showed that 42% had blood clots, including in their brains, lungs, liver and heart. “They never had the clinical syndrome of a thrombotic disorder. It caused silent damage,” Fuster said.
The doctors used different anticoagulants and often more than one on each patient, so it is not possible to say which worked best. But Fuster said low-molecular-weight heparin and apixaban both showed positive effects.
The Mount Sinai team published in May research results involving 2,000 patients. Wednesday’s report follows up with more patients being treated more consistently.
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