Doctors Want to Know: Could Blood Thinners Be Helpful for Covid-19?

People infected with the coronavirus also appear to have a high number of blood clots

Doctors are reporting evidence of yet another symptom of Covid-19, but the good news is this one is treatable and potentially lifesaving. In an interview with Elemental last week, infectious disease physician Gary Green, MD, mentioned that during regular calls with the Centers for Disease Control and Prevention, clinicians from around the country have shared anecdotal reports that Covid-19 patients in the ICU are experiencing a high number of blood clots.

“We’re learning that there seems to be a pro-coagulation effect, and a number of severely ill ICU patients are getting deep vein thrombosis at a much higher rate than we see in other ICU patients,” Green said.

It’s the latest bit of evidence that Covid-19 is in many ways acting more like a cardiovascular condition than purely a respiratory disease, likely because of the extreme inflammatory effect the virus can have on the immune system.

Now, Ethan Weiss, MD, a cardiologist at the University of California, San Francisco, has written an article for The Health Care Blog summarizing the observations about blood clots, explaining why they might be occurring and offering ways doctors could safely treat them. He writes that physicians have long known about a connection between inflammatory viral infections and blood clotting.

Clotting in response to an injury that causes bleeding is a good thing, but clotting for no reason can lead to tissue damage and death. As a result, there is a balance between pro-coagulant and anti-coagulant proteins in the body, plus a system that helps dissolve clots when they form. Inflammation can throw off this balance and result in more pro-coagulant factors and fewer anti-coagulant ones.

It turns out that doctors saw similar evidence of blood clotting during the 2003 SARS outbreak — a sister virus to the novel coronavirus — because the virus inhibited proteins that break down blood clots. Weiss suggests that a similar process may be occurring with the novel coronavirus, and doctors could start testing drugs that modulate the coagulation system on patients with Covid-19. He writes, “Clots, after all, are something we know how to treat, especially in an acute care setting.”