Are High-Dose Blood Thinners Needed for Severe COVID-19?

THURSDAY, Nov. 19, 2020 — Treating COVID-19 patients with high doses of blood thinners doesn’t appear to help them and could be harmful, researchers report.

“COVID-19 patients appear to have an increased incidence of blood clots. Many hospitals and health care providers began to use high doses of blood thinners to prevent these clots or treat them preemptively,” explained study co-author Dr. Juan Reyes, director of hospital medicine at George Washington University’s School of Medicine and Health Sciences, in Washington, D.C.

“We wanted to review the data of our subset of COVID-19 patients treated with blood thinners to determine if the higher-dose medication was helpful,” Reyes explained in a university news release.

At the beginning of the pandemic, all COVID-19 patients admitted to the university’s hospital received standard-dose anticoagulation, unless contraindicated, the researchers noted.

With increased awareness about the elevated risk of blood clots in COVID-19 patients, many began receiving high-dose blood thinners. Medical teams at the hospital were advised to consider giving non-critically ill patients a high dose of anticoagulation if their D-dimer levels were greater than 3 micrograms per milliliter.

Higher levels of the biomarker D-dimer — a medical indicator found in the blood — are associated with a higher risk of clinical deterioration and death from COVID-19.

Study first author Dr. Lei Lynn is an assistant professor of medicine at George Washington. She said, “While it’s true that COVID-19 patients could be dying of blood clots, the data we’ve evaluated does not support giving every patient a high dose of blood thinners. That’s a challenge, as the benefits still remain unclear. We caution against an aggressive blood thinner regimen for everyone, unless there is clear evidence to do so.”

The findings were published online recently in the journal Thrombosis Research.

Study co-author Dr. Karolyn Teufel, an assistant professor of medicine at George Washington, added, “Though we would have loved to have seen a clinical benefit to our patients from anticoagulation, our research found that higher doses of blood thinners were potentially harmful, with no clear benefits. Our research highlights the challenges with treating COVID-19. So much remains unknown.”

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