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Anticoagulants - drugs that prevent blood clotting - can improve the survival of hospitalized patients with COVID-19 by preventing possible heart attacks or strokes associated with the virus. This is the main result of a study published by The Journal of the American College of Cardiology (JACC) that, looking at the autopsy results of 26 patients with COVID-19, found that 11 of them (42%) had thrombi ( pulmonary, cerebral and / or cardiac).

The project, led by Valentín Fuster, director of the National Center for Cardiovascular Research (CNIC) and the Mount Sinai Heart Institute in New York, reveals that patients who receive both a therapeutic or full dose, as well as a prophylactic or lower dose of anticoagulants they have about a 50% greater chance of survival and about 30% less intubation than those who do not take anticoagulants .

At work, the researchers looked at six different anticoagulant regimens . Of all of them, therapeutic and prophylactic low molecular weight heparin and therapeutic apixaban achieved the best results.

"This observational study provides new information on the role of anticoagulation in the management of patients admitted with COVID-19 that we will confirm with the randomized study that we have started," said Fuster. In addition, the data have served to design a large-scale international randomized clinical trial , coordinated by this team that focuses on these three antithrombotic regimens: oral and subcutaneous heparin, and apixaban.

This work is an extension of the research published last May and in which 3,000 patients with COVID-19 participated. The analysis found that hospitalized patients responded better to anticoagulant treatment. The research was carried out in light of the fact that many of the hospitalized patients developed life-threatening blood clots .

mortality is reduced by 50%

In the new study, scientists evaluated the medical history of 4,389 coronavirus patients admitted to five different hospitals between March 1 and April 30, 2020 . Specifically, they analyzed and compared the survival and mortality rates of patients who received doses of anticoagulants and those who, on the other hand, did not have this treatment. To estimate the risk of death, other aspects such as age, ethnic origin or previous illnesses were considered.

Of the individuals analyzed, 900 (20.5%) received a full treatment dose of anticoagulants; 1,959 (44.6%) a lower dose of these, and 1,530 (34.5%) did not take these drugs. The data showed a strong association between anticoagulants and a reduction in the probability of in-hospital death : therapeutic and prophylactic doses of anticoagulants reduced mortality by approximately 50% compared to patients without anticoagulants.

Overall, 467 patients (10.6%) required intubation and mechanical ventilation during their hospitalization. Those taking therapeutic anticoagulants had 31% fewer intubations than those not receiving these drugs , while those treated with prophylactic anticoagulants were 28% less likely to be intubated. Therefore, the difference between the two groups of anticoagulants was not statistically significant.

Regarding the possible side effects of these drugs, the researchers found that the bleeding rates, a complication of anticoagulants, were around 3% on average, a very low figure. Of course, the percentage of bleeding was slightly higher in the therapeutic group than in the prophylactic groups and without anticoagulants. For this reason, it is important that clinicians evaluate each case to assess the benefit-risk ratio .

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  • Coronavirus
  • Covid 19
  • Pharmacology

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