The patients suffering from severe complications of Covid-19 and are treated with anticoagulants are half as likely to die than those not receiving these drugs, according to research led by cardiologist Valentin Fuster in the network of teaching hospitals Mount Sinai New York.
As a result of this research, New York hospitals have changed the way of treating the disease and are now administering anticoagulants to all patients admitted for Covid-19 except in cases where these drugs are contraindicated.
Research led by Valentín Fuster opens the way to improve treatment.
“I’ve never seen anything like what this virus does,” Dr. Fuster, who heads the Mount Sinai Cardiovascular Institute in the US, said in a telephone interview.
“Many severe cases have a major problem with excess clotting.” This coagulation disorder explains the myocardial infarctions, pulmonary embolisms, and strokes that occur in Covid-19 patients, which led Fuster to think that anticoagulants could improve the treatment of the disease.
Know the enemy
“I’ve never seen anything like what this virus does,” says the cardiologist.
“Antiviral drugs such as remdesivir are very important to act against the virus, but they are not enough to treat severe manifestations of the infection, which are what can cause the death of patients,” says the cardiologist, who has organized the investigation working from his Manhattan home.
To test whether anticoagulants can be useful, doctors at Mount Sinai have analyzed data from 2,773 patients admitted by Covid-19 until April 11 in the first phase of the project. At that time, they still did not administer anticoagulants to all cases of the disease, which has made it possible to compare those who received the treatment and those who did not.
According to the results presented yesterday in the journal JACC, among the patients connected to ventilators who did not receive anticoagulants, the mortality was 63%. Among those who did receive this type of drug, it fell to 29%, less than half. The percentages were similar for different anticoagulants, both injected and taken by mouth.
Among the deceased, the meantime in the hospital before death was 9 days without anticoagulants and 21 days with treatment. These twelve days of additional survival, although they may be of little relevance to patients, confirm that the treatment is effective.
US Hospitals have changed the way of treating patients because of these results.
“One of the issues we were most concerned about was that blood thinners could increase the risk of bleeding,” explains Dr. Fuster. But only 3% of patients who received these drugs had hemorrhages, compared to 1.9% of those who did not receive them. “This result gave us the confidence to extend the treatment to more patients.”
As, this is a retrospective study, based on data from patients who received the anticoagulants based on the situation in which each one was, the results do not demonstrate that the treatment is the cause of the reduction in mortality.
The Mount Sinai team is conducting another retrospective study using data from 5,000 patients treated in the past four weeks to validate the data obtained so far. And it plans to start two clinical trials in the coming weeks, these are prospective, to determine which is the best anticoagulant and at what dose for patients admitted to the hospital and for those requiring intensive care. A third clinical trial will test whether anticoagulants can be helpful for people with Covid-19 who are not admitted to the hospital.
At the same time, the Mount Sinai team is investigating with molecular biology techniques how coagulation disorder originates and progresses in patients with Covid-19.
“All the data that we are accumulating suggests that coagulation plays a central role in the serious forms of this disease,” says Valentín Fuster.
Although this line of research is in its infancy, “we have decided to publish the data as soon as possible because we are experiencing an exceptional emergency and these results may have important implications for improving the treatment of patients.” explains the cardiologist Fuster.
According to Johns Hopkins University, Worldwide Stats; LIVE DASHBOARD.
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