Deans' stroke musings: Antithrombotic treatment might help some with COVID-19

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, August 23, 2020

Antithrombotic treatment might help some with COVID-19

Is 'should' and 'might' strong enough words that your hospital will realize it is mandatory? I'm not taking any chances, I'm going to be demanding heparin as a blood thinner because of this:

Common FDA-approved drug may effectively neutralize virus that causes COVID-19

The latest here:

Antithrombotic treatment might help some with COVID-19

The coagulopathy often seen in patients with COVID-19 may be due to elevated levels of lupus anticoagulants and such patients might benefit from antithrombotic measures, an observational study suggests.

As Dr. Morayma Reyes Gil told Reuters Health by email, "Coronavirus disease presents with unusual coagulopathy. Our study demonstrates that lupus anticoagulants (LAs) are common in COVID-infected patients and that these patients may have increased risk of thrombosis."

LA is a prothrombotic antibody which may be present even in the absence of lupus erythematosus, Dr. Gil and colleagues at Montefiore Medical Center and Albert Einstein School of Medicine, in New York City, note in JAMA Network Open. Partial thromboplastin time (PTT) has been found to be prolonged in many patients with COVID-19 and may indicate the presence of LA, they add.

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To investigate, the researchers conducted a retrospective study of 187 LA-positive patients who had undergone testing in 2020. Most patients with COVID-19, they point out, have elevated levels of C-reactive protein (CRP) and CRP is known to interfere with LA PTT-based tests. Thus, LA positivity was mainly determined by dilute Russell viper venom time (DRVVT).

The LA-positive rate by DRVVT in the 119 patients who tested negative for COVID-19 was 22%, compared to 44% in the 68 patients who tested positive for COVID-19 (P=0.002).

Seventeen of the 30 patients who were positive for both COVID-19 and LA were also positive by hexagonal phospholipid neutralization STACLOT-LA test.

Mean prothrombin time and PTT were more prolonged in LA-positive compared with LA-negative patients. Of the 30 LA-positive COVID-19 patients, 19 had documented thrombosis (arterial and venous), for an event rate of 63%, which was significantly greater than the 34% seen in LA-negative patients.

After adjusting for CRP, LA was independently associated with thrombosis (odds ratio, 4.39).

"Our findings suggest that anticoagulation should be considered in COVID-hospitalized patients," concluded Dr. Gil.

—David Douglas