There’s no bigger priority in the United States right now than the pursuit of a safe, efficient treatment for COVID-19. New information suggests that a common, well-established medication may provide an important piece to the ultimate solution.
A Quick Introduction to Blood Thinners
Blood thinners, also known as anticoagulants, prevent blood clots from forming or getting larger. Since clots in the arteries, veins, and heart can cause heart attacks and strokes, blood thinners are frequently used to treat heart disease.
As the American Heart Association explains, “anticoagulants such as warfarin and heparin, slow clot formation by competing with Vitamin K. This inhibits the circulation of certain clotting factors.” Balancing each dose of blood thinner is essential, since a weak dosage increases risk of stroke and heart attack, while a strong dose creates the risk of bleeding.
The Connection Between Blood Clots and COVID-19
Evidence is emerging that ties COVID-19 to an increased risk of dangerous blood clots. Doctors around the world have reported mysterious blood clots that appear in gel-like or semisolid form. Autopsies even reveal unusual microclots in the lungs of many victims who died of respiratory arrest due to coronavirus.
Just as concerning, The New England Journal of Medicine published a report on April 28 to assess “five cases of large-vessel stroke in patients younger than 50 years of age who presented to our health system in New York City. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed in all five patients.”
Further south, in 10 hospitals across the Emory University health system in Atlanta, up to 40 percent of coronavirus patients had developed strange blood problems and clots. “That’s when we knew we had a huge problem,” explained Craig Coopersmith, a critical-care surgeon in Atlanta.
Famous broadway actor Nick Cordero, 41, is a prime example of this unprecedented and poorly understood phenomenon. Though fit and healthy before contracting the coronavirus, Cordero recently had his right amputated after COVID-19 triggered clots that blocked blood from getting to his toes.
According to Lewis Kaplan, a University of Pennsylvania physician and of the Society of Critical Care Medicine, standard clots behave differently than the clots observed in COVID-19 patients. “The problem we are having is that while we understand that there is a clot, we don’t yet know why there is a clot.”
Do Blood Thinners Offer a Solution?
Physicians at New York City’s largest hospital system teamed together to analyze 2,733 patients in a study published in the Journal of the American College of Cardiology. Valentin Fuster, a physician in chief at Mount Sinai Hospital and one of the study’s authors, explained that preliminary results indicate blood thinners could boost the prospect of survival for COVID-19 patients.
“My opinion is cautious, but I must tell you I think this is going to help. This is the opening of the door for what drugs to sue and what questions to answer,” he said.
The Mount Sinai study noticed significant results for patients on ventilators. About 63 percent of patients who did not receive blood thinner medications died compared with 29 percent who received treatment.
Doctors continue to work to find the right balance between clotting and bleeding, especially in patients with the most severe cases of COVID-19. Mount Sinai is now beginning a new trial with 5,000 randomized patients. The study will seek to definitively identify the best dosage and timing for blood thinners.