Written by: Cole Maguire
Edited by: Esther Melamed
Throughout the course of the COVID-19 pandemic, it has been recognized that a number of pressing secondary pathologies often develop in patients with severe COVID-19 disease. One of these secondary pathologies is COVID Associated Coagulopathy (CAC), which results in an over-abundance of clotting in the body and can contribute to strokes, heart attacks, and deep vein thrombosis. In order to combat this clotting, blood thinners, such as heparin are being tested in several trials, including ACTIV-4, REMAP-CAP, and ATTACC, to evaluate whether improving clotting abnormalities in COVID-19 could positively impact two primary health outcomes: time to discharge and reduced development of severe disease.
In a recent news release, the NIH has announced that full-dose heparin demonstrated efficacy in reducing need for ventilation and other organ support in moderate COVID-19 patients, outperforming low-dose heparin. This finding is based on data collected from approximately 1000 patients who have been hospitalized but who were not ventilated or in the ICU. These results contrast with earlier findings from December 2020 that reported full-dose heparin may have been harmful and did not demonstrate efficacy in critical COVID-19 patients in the ICU. While the official publication is pending where both the data’s strong and weak points will be presented, this news helps to guide clinicians in tackling this common COVID-19 complication and how to factor in severity when deciding on dosing of blood thinners.
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