A European study has found an elevated risk of a life-threatening blood clot called venous thromboembolism (VTE) in COVID-19 patients who were not critically ill.
The blood clot risk had previously been associated with severe COVID-19. However, the research warrants further study to corroborate the findings and that have yet to be certified by peer review.
The researchers tracked 2,292 patients who came to hospital emergency rooms with mild or moderate COVID-19 but without VTE. Four weeks later, VTE had developed in roughly 1 of every 200 mildly ill patients who had not been hospitalized and nearly 5 of every 200 moderately ill patients overall.
In hospitalized, moderately ill COVID-19 patients who have high levels of the d-dimer protein in their blood – indicating a higher-than-average risk for dangerous blood clots – treatment with high doses of the blood thinner low-molecular-weight heparin (LMWH) significantly reduced the odds of clot formation and death, according to data from a clinical trial.
The researchers said they launched the trial “because we saw patients getting blood clots and dying in front of us while on standard doses of preventative heparin.”
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Study leader Dr. Alex Spyropoulos of the Feinstein Institutes for Medical Research in New York said, “We were able to prove … that d-dimer levels more than four times the upper limit of normal can predict a very high-risk group of hospitalized COVID-19 patients – and giving therapeutic doses of heparin in these patients works,”
Knowing this, health care providers have changed the way they treat COVID-19 patients to specifically address the risk of clotting. It’s taken quick, widespread collaboration.
Those whose clotting systems aren’t particularly active receive treatments to prevent clots such as compression socks, inflatable cushions for their calves, or small injections of blood thinners. Those with more active clotting systems receive full doses of blood thinners if they’re not at a high bleeding risk.
“We’re having to be thoughtful about our approach with treatment, especially because there is limited data in COVID-19 patients,” said Tiffany Ortman, PharmD, a specialty practice pharmacist in outpatient care at the Ross Heart Hospital.
Recent news from both Europe and the United States has raised concerns about blood clots after the COVID-19 vaccination. It’s important to note that the most common vaccines in the U.S. — the Pfizer and Moderna vaccines — have not been found to have a high risk of blood clots.
Blood clots have been reported in Europe after the AstraZeneca vaccine and in the U.S. with the Johnson & Johnson vaccine, but these incidents have been extremely rare.
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