Anticoagulants Could Up Survival in COVID-19 Patients

Treating hospitalized COVID-19 patients with anticoagulants may improve their chances of survival, according to a new study.

Researchers at Icahn School of Medicine at Mount Sinai (New York, NY, USA) studied the medical records of 2,773 confirmed COVID-19 patients admitted to five hospitals in the Mount Sinai Health System in New York City (USA) between March 14 and April 11, 2020. All patients underwent blood analysis when they arrived at the hospital, including various inflammatory markers. The researchers then analyzed survival rates for patients placed on anticoagulants, compared to those who were not, as well as the association of systemic anticoagulant treatment with bleeding events.

Of the hospitalized COVID-19 patients analyzed, 28% received a full-treatment dose of anticoagulants. The results revealed that treatment with anticoagulants was associated with improved hospital survival, both in and out of the intensive care unit (ICU) setting. Of those who did not survive, anticoagulated patients died after an average of 21 days, compared to non-anticoagulant patients who died after an average 14 days. Anticoagulation also had a more pronounced effect on ventilated patients, with 62.7% of those not treated with anticoagulants dying, compared to 29.1% of those treated with anticoagulants.

An analysis of the blood studies in the medical record showed that patients who received anticoagulants had higher inflammatory markers compared to patients not treated with anticoagulants, suggesting that COVID-19 patients with a more severe illness may benefit from anticoagulants earlier on. The results also showed that among patients who did not receive anticoagulants, 1.9% suffered a bleeding event, compared to three percent among those who received anticoagulants. The study was published on May 6, 2020, in the Journal of the American College of Cardiology (JACC).

“This research demonstrates anticoagulants taken orally, subcutaneously, or intravenously may play a major role in caring for COVID-19 patients, and these may prevent possible deadly events associated with coronavirus, including heart attack, stroke, and pulmonary embolism,” said corresponding author Valentin Fuster, MD, PhD, physician-in-chief of Mount Sinai Hospital. “Using anticoagulants should be considered when patients get admitted to the ER and have tested positive for COVID-19 to possibly improve outcomes.”

“This study is opening the door for a more extensive study that will be carried out with 5,000 COVID-19-positive patients, where we will evaluate the effectiveness of three types of antithrombotic therapy -- oral antithrombotic, subcutaneous heparin, and intravenous heparin -- and then perhaps engage our data for prospective clinical trials,” said senior author Girish Nadkarni, MD, co-director of the Mount Sinai COVID Informatics Center. “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.”

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