Early Anticoagulant Treatment Found to Reduce Death in Moderately Ill COVID-19 Patients

Heparin, a blood thinner given regularly at a low dose to hospitalized patients, helps to stop clots from forming and reduces inflammation.

New trial results found that administering a full dose of a standard blood thinner early to moderately ill hospitalized patients with COVID-19 could stop the thrombo-inflammation process and reduce the risk of severe disease and death, according to a press release.

Heparin, a blood thinner given regularly at a low dose to hospitalized patients, helps to stop clots from forming and reduces inflammation.

"This study was designed to detect a difference in the primary outcome that included ICU transfer, mechanical ventilation or death," said study co-principal co-investigator Mary Cushman, MD, MSc, in a press release.

The open-label randomized international RAPID trial 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.

The primary outcome was a combination of ICU admission, mechanical ventilation, or death up to 28 days, with safety outcomes including major bleeding. The researchers found that the 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 with 18 who died 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 percent with therapeutic heparin," said first study author and co-principal investigator Michelle Sholzberg, MDCM, MSc, head of division of Hematology-Oncology, in the press release.

The researchers also presented a meta-analysis of randomized evidence, which specified that therapeutic heparin is beneficial in moderately ill hospitalized COVID-19 patients. In addition, another meta-analysis presented in the preprint showed that therapeutic heparin is beneficial in moderately ill hospitalized patients but not in severely ill ICU patients, according to the study authors.

"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 said in the press release.

REFERENCE

Early anticoagulant treatment shown to reduce death in moderately ill COVID-19 patients. EurekAlert! July 13, 2021. Accessed July 14, 2021. https://new.eurekalert.org/pub_releases/2021-07/lcom-eat071321.php