Hospitalized COVID-19 patients at increased risk of blood clots; anticoagulant therapy most efficient treatment: Study

The study was published in 'New England Journal of Medicine Evidence'. It was presented at the American Society for Hematology conference, the AustralaSian COVID-19 Trial (ASCOT).

By Newsmeter Network  Published on  15 Dec 2022 9:18 AM GMT
Hospitalized  COVID-19  patients at increased risk of blood clots; anticoagulant therapy most efficient treatment: Study

A new study has revealed that anticoagulant therapy is the most efficient level of blood thinning treatment for patients hospitalized with COVID-19.

The study was published in 'New England Journal of Medicine Evidence'. It was presented at the American Society for Hematology conference, the AustralaSian COVID-19 Trial (ASCOT).

The study was conducted in India, Nepal, Australia, and New Zealand by ASCOT. George Institute for Global Health oversaw operations in India and Nepal. ASCOT researchers aimed to discover which treatments are most effective in patients hospitalized with COVID-19.

Patients who were hospitalized for COVID-19 are at increased risk of blood clots (or thromboses), which in turn may contribute to the development of organ failure. Almost all these patients will receive some degree of blood thinning medication.

ASCOT team conducted a randomized clinical trial to test different levels of anticoagulation (or blood thinning) in more than 1,500 patients in Australia, New Zealand, India, and Nepal.

They found that an intermediate level of anticoagulation had an 86% probability of being better than low-dose anticoagulation. A higher therapeutic dose did not show any benefit.

ASCOT is an adaptive clinical trial that will generate clinical evidence about treatments for COVID-19 that can be applied during the pandemic to reduce mortality or the need for mechanical ventilation in hospitalized but not yet critically ill patients with COVID-19. Results will be continually analyzed so that ineffective therapies can be stopped, and new therapies can be evaluated as part of the trial.

ASCOT researchers investigated different types of treatments including Antiviral and antibody therapies – which aim to limit the virus replicating, Anticoagulation therapies – which aim to reduce the risk of blood clots associated with COVID-19 infection, etc.

ASCOT Principal Investigator Professor Steven Tong, an infectious diseases clinician at the Royal Melbourne Hospital and co-lead of clinical research at the Doherty Institute, said: "Current practice in Australia is for a low dose of anticoagulation, while international guidelines recommend a high therapeutic dose of anticoagulation. Therefore, our findings provide evidence that a middle ground may be most beneficial."

Consultant hematologist and associate professor Zoe McQuilten at Monash University Transfusion Research Unit Deputy Director, Australia, added: "We didn't find any evidence that the intermediate dose of anticoagulation resulted in an increased risk of bleeding. While we didn't find evidence of benefit from the high therapeutic dose of anticoagulation, we enrolled fewer patients into that arm of the trial."

Professor Bala Venkatesh, Fellow at George Institute for Global Health, Australia, stated, "This study highlights the importance of conducting clinical trials in different health care systems. The results of the ASCOT trial are expected to have a significant influence on clinical guidelines."

Professor Vivekanand Jha, Executive Director at George Institute for Global Health, India said, "Even as the case numbers were low in Australia and New Zealand, existing network relationships allowed us to take the trial to India and Nepal, where COVID-19 was active and successfully complete this study that asks a question of global relevance."

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