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Blood thinner may reduce death risk in moderately ill COVID-19 patients: Study

COVID-19 is marked by heightened inflammation and abnormal clotting in the blood vessels, particularly in the lungs, and is believed to contribute to progression to severe disease and death.

July 14, 2021 / 05:22 PM IST
Image: Shutterstock

Image: Shutterstock

Administering a full dose of a standard blood thinner early to moderately ill hospitalised patients with COVID-19 could halt the formation of blood clots and reduce the risk of severe disease and death, according to a study.

COVID-19 is marked by heightened inflammation and abnormal clotting in the blood vessels, particularly in the lungs, and is believed to contribute to progression to severe disease and death.

The researchers at St. Michael's Hospital and the University of Vermont Larner College of Medicine in Canada noted that heparin -- a blood thinner given regularly at low dose to hospitalised patients -- stops clots from forming and reduces inflammation.

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The yet-to-be-published study, post on the preprint server MedRxiv, examined the benefits of administering a therapeutic full dose of heparin versus a prophylactic low dose to moderately ill patients admitted to hospital wards with COVID-19.

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COVID-19 Vaccine

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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"This study was designed to detect a difference in the primary outcome that included ICU transfer, mechanical ventilation or death," says Mary Cushman, study co-principal investigator and a professor at the University of Vermont's Larner College of Medicine.

The primary outcome was a composite of ICU admission, mechanical ventilation, or death up to 28 days, the researchers said, adding that safety outcomes included major bleeding.

Primary outcome occurred in 37 of 228 patients with therapeutic full dose heparin, and 52 of 237 with low dose heparin.

Four patients with therapeutic heparin died compared to 18 with prophylactic heparin.

"While we found that therapeutic heparin didn't statistically significantly lower incidence of the primary composite of death, mechanical ventilation or ICU admission compared with low dose heparin, the odds of all-cause death were significantly reduced by 78 per cent with therapeutic heparin," said first author and co-principal investigator Michelle Sholzberg, an assistant professor at the University of Toronto.

Peter Juni, a co-principal investigator, from the University of Toronto, said that the research clearly indicated that therapeutic heparin is beneficial in moderately ill hospitalised COVID-19 patients.

The study showed that therapeutic heparin is beneficial in moderately ill hospitalised patients but not in severely ill ICU patients, he said.

"We believe that the findings of our trial and the multiplatform trial taken together should result in a change in clinical practice for moderately ill ward patients with COVID-19." Sholzberg added.

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PTI
first published: Jul 14, 2021 05:21 pm

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