Exactly what I've been recommending for months, I'm going to be asking for heparin immediately.
Heparin:
Why I'm getting heparin. Heparin binds to cells at a site adjacent to ACE2, the portal for SARS-CoV-2 infection, and "potently" blocks the virus, which could open up therapy options.
Anticoagulation Again Shown to Improve Survival in COVID-19 Patients;-Mortality risk about 50% lower
But this research below suggests not due to bleeding risks. I'll take that risk since I've been on warfarin, aspirin and had Lovenox shots.
COVID-Related Strokes Especially Severe, Result in Worse Outcomes
The paragraph from there:
"On the other hand, in most patients with COVID-19 associated ischaemic stroke, very early anti-coagulation is probably not warranted as a strategy to prevent inpatient stroke recurrence, as this outcome is too uncommon to justify the increased risk of secondary haemorrhage," according to the group.(So you wait until the clots are severe before you do anti-coagulation. OK, not for me.)
The latest here:
Study suggests anticoagulation prior to hospitalisation associated with better prognosis in patients with COVID‐19
Anticoagulation therapy prior to hospitalisation, compared with anticoagulation initiated during hospitalisation, was associated with a better prognosis in patients with coronavirus disease (COVID-19), according to a study published in the Journal of the American Heart Association.
“Using a multicenter French study of patients hospitalised for COVID-19, we provide evidence that previous oral anticoagulation with vitamin K antagonist or direct oral anticoagulant significantly decreased intensive care unit (ICU) admission or in-hospital mortality,” wrote Richard Chocron, MD, Université de Paris, Paris, France, and colleagues. “Furthermore, in patients without anticoagulation prior to hospitalisation, anticoagulation started during hospitalisation (heparin or low-molecular weight heparin) was not associated with a better prognosis.”
The retrospective observational study included 2,848 patients admitted to 24 French hospitals from February 26 to April 20, 2020, of whom 382 (13.4%) were treated with oral anticoagulation therapy prior to hospitalisation. Of these patients, physicians decided to pursue anticoagulation for 341 (90.0%) patients, whereby 58 (15.2%) patients were on prophylactic low dose, 9 (2.4%) were on prophylactic high dose and 274 (71.7%) were on therapeutic dose anticoagulation during hospitalisation. Among the remaining 2466 patients, 1,478 (59.9%) received prophylactic low dose, 261 (10.6%) received prophylactic high dose and 246 (10.0%) were treated with therapeutic anticoagulation during hospitalisation. Overall, patients receiving oral anticoagulation prior to hospitalisation were older (P <0.001) and had significantly more cardiovascular risk factors.
In the multivariable adjusted Cox regression model, researchers found that anticoagulation therapy prior to hospitalisation was associated with a better prognosis (lower risk of ICU admission or in-hospital mortality) with an adjusted hazard ratio (aHR) 0.70 (95% confidence interval [CI], 0.55-0.88; P = 0.003). Analyses performed using propensity score matching further confirmed that anticoagulation therapy prior to hospitalisation was associated with a better prognosis with an aHR of 0.43 (95% CI 0.29–0.63; P<0.001) for ICU admission and aHR of 0.76 (95% CI 0.61–0.98; P = 0.04) for composite criteria ICU admission and/or death.
Conversely, the researchers did not observe significant association between the use of anticoagulation during hospitalisation for any regimen (prophylactic low or high dose and therapeutic dose) and in-hospital mortality as well as ICU admission.
“Anticoagulation in early step of disease could better prevent COVID-19-associated coagulopathy and endotheliopathy,” the authors noted. “Introduction of anticoagulation in ambulatory patients in case of close contacts with confirmed COVID-19 patients represent a new potential therapeutic approach.”
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