Doctors Trial Anticoagulants to Save Serious Patients With COVID-19

A woman was dying. Mt. Sinai Hospital in New York was about to call the husband and tell him there were no more resources. So Dr. Hooman Poor decided to risk something new.

In the frantic search for treatment and making stressful, high-risk decisions, doctors around the world are trying to figure out how COVID-19 kills their patients. A theory that gains acceptance is that small blood clots plug the lungs of the most seriously ill.

Poor couldn’t prove it. The required tests would mean more danger for his collaborators, who were already at risk of getting it, but the lung specialist saw clues that “cried out blood clots.” He then supplied a known medicine for the treatment of heart attacks and held his breath..

“I thought, ‘what can we lose? ’” Poor told The Associated Press. “So I decided to give him not only a blood thinner but a blood thinner.” The effect of clots in at least some COVID-19 sufferers is a mystery. The study who collected all the treatment was published by the Mount Sinai Hospital.

Chinese doctors were the first to notice it. In March, Chinese cardiologists advised the American College of Cardiology to monitor clots, and said certain blood tests showing an increased risk of clots could indicate which patients were most at risk.. Other reports highlighted that clots could appear throughout the body. But were they a cause or consequence of the deterioration?

Many hospitals are already testing preventive doses of diluents to prevent clots from forming. There is already a debate about the class of anticoagulants to use, what is the safe dose, because these medicines can cause dangerous bleeding and the dilemma seems to be when to start treatment.

In New York, Poor went one step further with a medicine called tPA, which does not prevent clots, but breaks them.. This is an example of how, in the absence of a vaccine or an approved treatment for coronavirus, many doctors follow the trails and clues in search of something that can be tried to save a life.

The 55-year-old patient died of a series of complications., but the team of Poor tested blood clot treatment on four more seriously ill patients, one of whom did not survive., struck down by a huge clot that caused him to cardiac arrest.

In the others, there were improvements in oxygen levels. After a few days, three were on respirators and doing well, especially a patient who had received immediate treatment for lung failure. Poor has called for an urgent study to be carried out on whether abnormal coagulation is the cause of the deterioration in some patients.. Meanwhile, her hospital has updated tips for treating more serious cases.

Others follow the same track. Specialists at the universities of Colorado and Harvard recently published reports on the similar use of tPA and cited three additional cases.

“We treat extremely serious patients who die without being able to test diagnoses, but still we are required to make decisions about treatment ”reflected Dr. Steven Pugliese, a lung specialist at the University of Pennsylvania.

Pugliese said Poor’s report on tPA is “extremely interesting,” adding that “these doctors for seriously ill patients had to make decisions based on their good judgment, and they did well.”

But “given the danger of bleeding, it should be studied in carefully chosen patients ”Pugliese warned, especially since there is no way to determine in advance who has the small clots.