Pune: Common blood thinner drug proves lifesaver during Covid

PUNE: A common blood-thinning drug — Low Molecular Weight Heparin (LMWH) — has emerged as a potential therapeutic treatment for Covid-19 patients.

Doctors said the drug — as a subcutaneous injection — has helped reduce hospitalisation periods, improved recovery rate and has significantly cut the rate of sudden deaths by over 90%. Encouraged by the outcomes, specialists TOI spoke to said doctors nationwide were now using the drug as a prophylactic (preventive) therapy to counter blood inflammation and clotting — two main complications SARS-CoV-2 has been causing in the human body.
The doctors’ logic is simple: It is easier to prevent new blood clots/inflammation from forming, compared to treating existing blood clots or inflammation. Pune-based critical care expert Subhal Dixit said, “Post-mortem reports from Italy showed that Covid-19 causes small blood clots (micro-thrombus) in blood vessels, along with inflammation.”
Dixit said, “Doctors in India have been using blood thinners, mainly LMWH, since the start of the pandemic. But their use has now increased manifold. Evidence of their efficacy is also growing.”
Dixit is a former national president of the Indian Society of Critical Care Medicine (ISCCM), a pan-India body of intensivists.
The formation of clots in the lung vessels leads to respiratory complications. “Similarly, small blood clots in vessels in the heart, brain and the kidneys can trigger heart attacks, brain strokes and acute kidney injury in moderate to critically ill Covid-19 patients. The LMWH has proven to be extremely beneficial in averting such complications,” Dixit said.
A blood test called D-dimer is first carried out to rule out blood clots in patients. In Covid-19 cases, the D-dimer is often elevated.
“The elevation of D-dimer is indicative of a risk of blood vessel inflammation and blood clotting. The LMWH, along with antiplatelet drugs, has countered both complications and has significantly cut Covid-linked mortality,” Rohtak-based critical care expert, Dhruv Chaudhary, the national president of the ISCCM told TOI.
These evolving treatment strategies, including the use of LMWH, have helped doctors ensure maximum Covid-19 recoveries.
Mumbai-based Nanavati hospital’s intensivist, Ujwala Mhatre said, “In the marathon that is Covid treatment, anticoagulation drugs such as LMWH are valuable tools to prevent multiple mechanisms involved in Covid-associated thrombosis.”
Delhi-based critical care expert Yatin Mehta head of the ICU at Medanta hospital said, "Small preventive dose of LMWH to admitted patients with increased D-dimer has given remarkable results. A few critical patients need a larger dose though."
Critical care expert Kapil Borawake, said, “The LMWH has emerged as the drug of choice — a sort of pre-requisite prophylactic during the treatment of hospitalised Covid patients. Its administration should not be delayed during the early phase of the illness. Recovered patients with pre-existing conditions are also advised to continue the drug in oral form even after discharge.”