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High-Dose Anticoagulation May Not Aid COVID-19 Patients

FRIDAY, Nov. 20, 2020 -- Higher doses of blood thinners are potentially harmful and have no clear benefits for hospitalized COVID-19 patients, according to a study published online Nov. 5 in Thrombosis Research.

Lei Lynn, M.D., from George Washington University in Washington, D.C., and colleagues retrospectively analyzed patient data from 402 COVID-19 patients hospitalized between March 15 and May 31, 2020. Comparisons in clinical outcomes were evaluated for 152 patients treated with therapeutic anticoagulants (AC) and 250 patients on prophylactic AC.

The researchers observed increased mortality associated with therapeutic AC (odds ratio, 3.42) versus prophylactic AC. Similar survival curves were seen among a subset of critically ill and intubated patients, regardless of AC dose. The favoring of prophylactic AC disappeared among non-intensive care unit patients when the analysis was stratified by D-dimer levels less or greater than 3 μg/mL. Clinically significant bleeding or thrombocytopenia was seen in approximately 9 percent of patients receiving therapeutic AC versus 3 percent in those receiving prophylactic AC.

"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," Lynn said in a statement. "We caution against an aggressive blood thinner regimen for everyone, unless there is clear evidence to do so."

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Posted: November 2020

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