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Study: Blood thinners helping COVID-19 patients after they're released

The study of blood thinners examined 4,906 adults

The study of blood thinners examined 4,906 adults who were hospitalized with COVID-19 at Northwell Health facilities in the New York metro area. In the photo, a medical staff person shows drugs used to treat COVID-19 patients, including blood thinners. Credit: BSIP/Universal Images Group via Getty Images

High-risk COVID-19 patients who continue to take blood thinners after they are released from the hospital have lower rates of major blood clots and death, according to a study by the Long Island-based Feinstein Institutes for Medical Research.

Medical experts said the findings are key because researchers are still trying to understand and manage the long-term effects of COVID-19. Some patients have complained of fatigue, shortness of breath, joint pain and other symptoms months after first being diagnosed with COVID-19.

"We knew that the risk of blood clots was very high in hospitalized patients, and this is why we are giving them blood thinners," said Dr. Alex C. Spyropoulos, professor at the Feinstein Institutes for Medical Research and principal investigator on the study. "What we didn’t know before the study [was] that there was a real risk of blood clots after patients leave the hospital."

The study examined 4,906 adult patients who were hospitalized with COVID-19 at 12 different Northwell Health facilities on Long Island and in the region between March and May 2020. It was published in Blood, the medical journal of The American Society of Hematology.

Spyropoulos said high-risk patients — those over the age of 75 with cardiovascular issues, kidney disease and other health concerns — had a 46% less risk of getting major thrombosis (blood clots in veins or arteries) or dying if they continued on a course of blood thinners for at least 30 days and up to 45 after leaving the hospital.

"I think based on these findings, every hospital in the United States should consider giving blood thinners to these high-risk hospitalized COVID-19 patient groups," Spyropoulos said "As we await results of definitive randomized trials … This could impact millions of patients across the U.S."

Doctors have found that some patients who contract COVID-19 can experience a heightened response from their immune systems, creating inflammation and an increased risk of blood clots.

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Spyropoulos said the risk can be up to fives times higher than what was experienced by patients with these same health issues before the COVID-19 pandemic.

"What we showed now for the first time was that this risk persists after patients leave the hospital," he said. "That's new, and that's worrisome."

Of the 4,906 patients who were followed in the study, 7.1% suffered major blood clots or died. But of the 13% of those patients who received post discharge blood thinners, there was a 46% reduction in the risk for major clots and death.

"Despite only 13% of the population receiving post discharge blood thinners, we saw a significant treatment effect, which is remarkable," he said. "If it was 50% or 60% of the population, we may expect to see a treatment effect since it's a large number."

Some patients may have refused to take blood thinners, since they come with a risk of heavy bleeding, Spyropoulos said. Others may not have had insurance coverage to pay for the medication.

Spyropoulos said he would like to see the results of the study on blood thinners and high-risk hospitalized patients who are released in a randomized clinical trial.

"This study reveals it is important to monitor COVID-19 survivors for dangerous blood clots even after they leave the hospital," Dr. Kevin J. Tracey, president and CEO of the Feinstein Institutes, the research division of Northwell Health, said in a statement. "By studying the enormous patient population treated at Northwell Health, Dr. Spyropoulos and his team have laid a solid foundation guiding future clinical trials."

Tracey has advocated for clinical trials and studies centered on how existing drugs can help people who contract COVID-19.

Feinstein is conducting a clinical trial to study the safety of using heparin, a blood thinner, to prevent clots in hospitalized patients, as well as a trial examining the use of famotidine, commonly known as the heartburn drug Pepcid, in COVID-19 patients with mild to moderate symptoms who have not been hospitalized.

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