Drugs to thin blood can prevent virus deaths
Hopes raised of breakthrough treatment as doctors hail anti-clot medicine as a life saver
BLOOD-thinning drugs can help save Covid-19 patients’ lives, leading British doctors have found, raising hopes of a major breakthrough in the race to find a treatment for the deadly virus.
London specialists made the discovery after finding Covid-19 caused potentially deadly blood clots in the lungs of most patients who die.
NHS England is set to issue hospitals with fresh guidance on blood thinning, which is likely to eventually lead to carefully administered higher doses for the critically ill.
Prof Peter Openshaw, who sits on the Government’s Scientific Advisory Group for Emergencies (Sage) subgroup on clinical information, said an “unprecedented amount of collaboration” between scientists had revealed
“a really quite extraordinary story about a virus about which we hitherto knew nothing”.
Specialists at the Royal Brompton Hospital’s severe respiratory failure service established the clearest link yet between Covid-19 and clotting by using hi-tech dual energy CAT scans to take images of lung function in their most serious patients.
All of those tested suffered a lack of blood flow, suggesting clotting within the small vessels in the lung. This partly explains why some patients die of lung failure through lack of oxygen in the blood, the doctors told The Sunday Telegraph. Low oxygen levels have been regularly recorded in Covid patients reporting no breathlessness.
Prof Openshaw, a specialist in experimental medicine at Imperial College London and honorary physician at St Mary’s Hospital, said: “This intravascular clotting is a really nasty twist that we haven’t seen before with many other viruses. It does sort of explain the rather extraordinary clinical picture that is being observed with people becoming very hypoxic, very low on oxygen and not really being particularly breathless. That would fit with it having a blood vessel origin.”
The evidence means randomised clinical trials to test blood-thinning – or anticoagulant – agents on Covid patients are being fast-tracked as part of the Government’s urgent research portfolio into potential solutions to the pandemic. The new NHS England guidance is independent of the work, and is believed to have been issued on the advice of haematology specialists.
Doctors involved in the findings at the Royal Brompton underlined the need for careful use of blood thinning medication, which can in itself have deadly consequences. Leading specialists warned anticoagulant use must be a “personalised approach” by clinicians. Treatment would need to “start very early” to prevent clots forming.
Dr Brijesh Patel, a senior intensivist at the Royal Brompton and Imperial, said: “I think the majority of patients will end up on significant therapeutic doses of blood-thinning agents as we learn more about this disease.
“If these interventions in the blood are implemented appropriately, they will save lives.”
Dr Patel added: “I think it is important to introduce blood-thinning agents that are associated with Covid, but you have to do it in the right way, otherwise you can cause harm.”
Doses of low-molecular-weight heparin – used to reduce the risk of clots, deep vein thromboses and pulmonary embolisms – are already being routinely used in smaller doses for hospital patients, partly because of the length of time they spend immobile in bed.
Dr Patel’s team treated and studied more than 150 of some of the UK’s most critically ill patients. Using hi-tech CAT scans they established that injury to the lungs was “a lot more apparent” among Covid sufferers than it would be among other patients suffering lung failure. The doctors will publish their initial findings next week.
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136,486 DAILY TESTS 36,486 ABOVE TARGET