Blood thinning drugs used to treat heart disease could more than halve death rates from Covid-19, according to new research.
Some patients who succumb to the potentially deadly virus develop hundreds of tiny clots in their lungs, autopsies have shown.
Now a study has found the anticoagulant heparin dramatically improves outcomes for hospitalised patients – especially the most sick.
Just under three in ten of those on ventilators died – compared to over six in ten of those who were not given the medication
The therapy also sped up recovery time for those that did not need to be placed in intensive care – relieving pressure on doctors and nurses.
The discovery published in the Journal of the American College of Cardiology offers hope of a more effective way to look after for the seriously ill.
Senior author Professor Valentin Fuster, physician-in-chief at The Mount Sinai Hospital, said: “This research demonstrates anticoagulants taken orally, subcutaneously or intravenously may play a major role in caring for Covid-19 patients.
“These may prevent possible deadly events associated with coronavirus including heart attack, stroke and pulmonary embolism.”
Anticoagulants carry a risk of internal bleeding. But the difference in these events among those treated with or without them was not significant.
The work outlines an important therapeutic pathway for Covid-19 patients, say the Mount Sinai COVID Informatics Centre team.
Prof Fuster added: “Using anticoagulants should be considered when patients get admitted to the ER and have tested positive for Covid-19 to possibly improve outcomes.
“However, each case should be evaluated an individualised basis to account for potential bleeding risk.”
The drugs are commonly used to slow down clotting in patients at risk of a heart attack or stroke.
Previous research at the Icahn School of Medicine at Mount Sinai has identified life threatening clots in many hospitalised Covid-19 patients. These can cut off blood supply, causing a heart attack or stroke.
Co-researcher Dr Anu Lala, of the Icahn School of Medicine, said: “As a cardiologist who has been on service caring for Covid-19 patients for the last three weeks, I have observed an increased amount of blood clot cases among hospitalised patients.
“So it is critical to look at whether anticoagulants provide benefits for them. It is important to note further analysis and prospective studies are required to determine the effectiveness for widespread use of anticoagulants in hospitalised Covid-19 patients.”
(Image: Getty Images/Cultura RF)
The researchers evaluated the records of 2,773 confirmed Covid-19 patients, specifically comparing survival rates of those given blood thinners with those who were not.
The drugs had the most pronounced effect on ventilated patients – 63 percent of who were not treated with them died, compared to 29 percent of those who were.
What’s more, the former group died after an average of 9 days, compared to 21 days for the latter.
Overall, 786 (28%) received a full-treatment dose of anticoagulants usually given to those believed to already have clots. This is more than the normal preventative dose.
The therapy was associated with improved hospital survival among Covid-19 patients “both in and out of the intensive care unit setting”, said the researchers.
Of the patients who did not survive, those on anticoagulants died after spending an average of 21 days in hospital, compared to 14 days for the others.
The participants were admitted to five hospitals in the Mount Sinai Health System in New York City between March 14 and April 11.
Blood samples were taken when they arrived. The analysis found patients who received anticoagulants had higher inflammatory markers.
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This may suggest those with more severe illness may benefit from anticoagulants early on.
Among those who did not receive anticoagulants, 38 (1.9%) suffered bleeding events, compared to 24 (3%) among those given them.
Prof David Reich, president and chief operating officer of The Mount Sinai Hospital, said: “We are hopeful this report of the association of anticoagulation therapy with improved survival will be confirmed in future investigations.
“The astute scientists at Mount Sinai continue to analyse our data on Covid-19 patients in order to contribute to worldwide efforts to find effective treatments.”
A more extensive study of 5,000 Covid-19-positive patients will now be carried out to evaluate administering heparin orally, with an injection or intravenously.
Senior author Dr Girish Nadkarni, co-director of the Mount Sinai COVID Informatics Centre, said: “We are excited about these preliminary results that may have a positive impact on Covid-19 patients and potentially give them a greater chance of survival, although more studies are needed.”
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