. . Weltnachrichten – GB – Trial with high-dose blood thinners in I. . C.. . U. . Patients are stopped

Administering anticoagulants to hospitalized Covid-19 patients is routine. But high doses can sometimes do more harm than good, says a security agency.

A large study with high-dose blood thinners in critically ill Covid-19 patients in the hospital is temporarily canceled because the treatment appears to be of no benefit and may cause harm, the study directors announced on Tuesday.

The independent monitoring body that called for the trial to be interrupted did not disclose what potential harm it had found. High doses of anticoagulants are known to cause uncontrollable bleeding – in places, including the inside of the skull, that can be very dangerous.

The leaders of the study are urging to get the word out that the study has been suspended because some hospitals are still aggressively treating their intensive care patients with high doses of anticoagulants, believing that the benefits outweigh the risks while the opposite is true the case can be true.

« We need to make this pause in the study widely known because of the potential harm, » said Dr. . Matthew D. . Neal, a surgeon and critical care specialist at the University of Pittsburgh Medical Center who is leading one of many teams on the study.

The teams in the study, about 3. 000 patients in multiple countries will study the data carefully to see if enrollment in the branch of the study, which focuses on critically ill hospital patients, can restart.

It is well known that Covid-19 causes clusters of small blood clots that block capillaries and can cause damage to the lungs, kidney, heart, brain or other organs and even fingers and toes. Low doses of blood thinners are routinely given to hospitalized Covid-19 patients as soon as they are admitted. Dr. . Said Neal.

The branch of the study of giving high doses of blood thinners to patients who are moderately ill will continue.

The moderately ill patients generally include those who receive oxygen but are not in intensive care, on ventilators, or at risk of other organs such as the kidneys failing.

In October, an observational study in the Journal of the American College of Cardiology found that hospitalized Covid-19 patients who were given blood thinners did much better than those who weren’t. In this study, there was little difference in results or negative side effects between those given low or high doses.

Based in part on this study, many doctors believed that when some amount of anticoagulant is good for most patients, the sickest patients should be given the largest doses, said Dr. . Jeffrey S.. . Berger, director of the Center for the Prevention of Cardiovascular Disease at New York University Medical School and another lead researcher in the paused study.

« Hopefully this will be humble, » said Dr. . Berger said of the new evidence that large doses could be harmful. “It helps us realize that we don’t have all the answers. ”

Anticoagulants are known to cause bleeding under the skin and gastrointestinal tract, as well as wounds that do not heal if the skin is pierced.

Bleeding in the skull is rare but can cause permanent brain damage or death, Dr. . Berger noticed.

Dr. . Neal said he treated Covid victims “with problems on both ends of the spectrum: patients with blood clots and patients with bleeding. ”

One of the goals of the process, Dr. . Neal said the task was to find out which patients were most likely to benefit from anticoagulants.

Patients are often tested for D-dimer, a breakdown product of blood clots, and for C-reactive protein, a marker of inflammation that may be associated with clotting. It would be useful to know Dr. . Neal said whether these tests could accurately predict which patients high doses of anticoagulants would help the most.

The interrupted study is a large, coordinated effort by what was once three separate clinical study groups in multiple countries. It is jointly funded by the National Institutes of Health and their counterparts in Canada, the United Kingdom, Australia and the European Union.

« This is the most collaborative thing I’ve been involved in in all of my time in medicine, » said Dr. . Said Neal.

Anticoagulant, clinical trial, coronavirus, intensive care unit