COVID Patients In ICU May Experience Heavy Bleeding When Given Full-Dose Blood Thinners

Caution should be exercised when selecting a regimen to treat blood clots in mechanically ventilated patients with COVID-19, said researchers at the University at Buffalo.

COVID-19 causes blood clots in some patients. Most cases of thrombosis are seen in people who are hospitalized with severe COVID-19 symptoms. Anticoagulants (blood thinners) are sometimes prescribed in hospitalized COVID patients to prevent complications and reduce death risk. But a new study has warned that full-dose blood thinners may cause severe bleeding in COVID patients.

The study led by researchers at the University at Buffalo, found that nearly 1 in 7 COVID patients in the intensive care unit (ICU) experienced severe bleeding when given full-dose blood thinners.

However, a smaller yet equally effective dose carries less bleeding risk, said the study, published last month in Hospital Pharmacy.

Safety and effectiveness of blood clot treatmentin COVID-19 patients

The study, which included more than 150 critically ill COVID-19 patients, who received either of two blood thinner regimens: a full-dose based on patient levels of D-dimer (a protein present in the blood after a blood clot dissolves), and the other a smaller but higher-than-standard dosage.

According to the researchers, almost all patients who experienced significant bleeding were mechanically ventilated and receiving full-dose blood thinners.

Significant bleeding events were seen in nearly 14 per cent of patients who received full-dose blood thinners while it was seen in only 3 per cent of patients who received a higher-than-standard dosage. However, the researcher found no difference in the regimens' effectiveness at treating blood clots.

Study's first author Maya Chilbert, PharmD, clinical assistant professor in the UB School of Pharmacy and Pharmaceutical Sciences, noted that health care providers should exercise caution when selecting a regimen to treat blood clots in mechanically ventilated patients with COVID-19.

"The decision to use full-dose blood thinners should be based on a compelling indication rather than lab markers alone," Chilbert said, as quoted by Science Daily.

But the expert also underscored the need for further study to determine the optimal strategy for treating blood clots and bleeding in hospitalized COVID-19 patients.