Heparin helps break down the microthrombi that prevent oxygen from passing from the alveoli to the small pulmonary arteries. Photo: Bigstock
Anticoagulant heparin reduces the risk of dying from complications of Covid-19 by 78% if given at a dose four times the dose recommended today by the World Health Organization (WHO).
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This dose, called therapeutic, must be administered as soon as the patient arrives at the hospital with signs of respiratory failure. The dose indicated by the WHO is said to be prophylactic, indicated to prevent thrombosis, and has shown no benefit.
Heparin helps to break down the microthrombi which prevent oxygen from passing from the alveoli to the small pulmonary arteries and, in addition, helps in the recovery of the vascular endothelium.
This is the result of the randomized clinical trial, a study of which was published last Thursday (14) in the British Medical Journal, involving 465 patients treated in 28 hospitals in six countries, including Brazil. The information comes from the FAPESP Agency.
Changing the use of anticoagulants
“We believe these results should change clinical practice,” said Dr Elnara Negri, co-author of the article and team member at Hospital das Clínicas, Faculty of Medicine, University of São Paulo (FM-USP ) and at Sírio-Lebanese Hospital.
The researcher emphasizes, however, that the recommendation is not valid for all people diagnosed with Covid-19. “The treatment is only indicated for hospitalized people and only under medical supervision. If a person takes blood thinners without the need or advice, they can bleed to death. “
“We did not see a significant difference in terms of the need for intensive care admission, non-invasive ventilation or intubation. But the number of deaths was significantly lower in the group that received the therapeutic dose. And the occurrence of major bleeding, which was the main adverse effect observed in the study, was very low. In other words, the therapy is safe, ”explains the doctor.
what time to use
The results also show that, to provide benefit, heparin should be administered between the 7th and 14th day after the onset of symptoms. Previous studies had already shown that anticoagulation does not bring important results when it is carried out after admission to intensive care.
The doctor points out that the benefits at this stage of the disease were only seen with the use of injectable heparin. Oral anticoagulants had no effect. “This may be due to the fact that this drug also has antiviral and anti-inflammatory effects already confirmed in the context of Covid-19. The good news is that this is an inexpensive drug available in the SUS. [Sistema Único de Saúde]. “