Irish researchers study effectiveness of blood thinners on coronavirus

Irish researchers are taking part in a large international study to determine if blood thinners could help change the progression of coronavirus and prevent patients from requiring intensive care, a leading professor in clinical medicine has said.

Prof Fionnuala Ní Áinle, a consultant haematologist and professor in University College Dublin, said UCD scientists were leading the Irish part of the trial – known as Rapid – which aims to understand the "very best way" to use blood thinners, such as heparin, to have an impact on disease progression.

“We have very good data already that a preventative dose of heparin protects patients from developing blood clots when they’re in hospital. There are signals from a number of studies around the world that heparin has anti-inflammatory and other mechanisms that could actually impact on disease progression of Covid-19,” Prof Ní Áinle told The Irish Times.

“There is one study in particular which has suggested that heparin can actually improve outcome in the sickest patients. But we simply don’t know on a large scale whether a higher dose of heparin will do just that – protect patients from progressing to need intensive care or ventilation.”

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‘Multicentre trial’

She added: “The purpose of this study is to determine in a large multicentre trial whether the effects will be observed.”

The trial is being led by Dr Michelle Scholzberg in Canada, and follows various studies showing individuals admitted to hospital with severe Covid-19 infection are experiencing abnormal clotting that contributes to death in some patients.

One study, published by the Royal College of Surgeons in Ireland (RCSI) last week, found that Irish patients with severe Covid-19 experienced micro-clots within the lungs.

The authors also found that Irish patients with higher levels of blood clotting activity had a significantly worse prognosis and were more likely to require ICU admission

Prof Niamh O’Connell, consultant haematologist and director of the coagulation centre at St James’s Hospital, said the clotting in the lungs and legs of coronavirus patients is “contributing to the severity of the illness”.

Role for anticoagulants

"There's no doubt that risk-assessing people for risk of clotting and giving them preventative blood thinners or low molecular weight heparin is really important," she told RTÉ Radio One's This Week.

“But we feel there may be a role beyond this for blood thinners or anticoagulants and that they may help to reduce the amount of inflammation and to help people to recover from the illness but this isn’t proven at the moment.”

Prof Ní Áinle said the Rapid trial is an “acute priority” among the medical community and that “the number of partners who are interested [in participating] is growing by the day”.

“There are a number of clinical trials that are of a similar design being done around the world so there is a good probability that we will have an answer to this important question within the next six months,” she said.

“Clinicians and scientists from around the world will work together to get an answer to these questions because only by working together as international collaborators can we truly make progress, particularly at a time like this, during a pandemic, when so many challenges face us.”