Anticoagulation is the answer in treating noncritical COVID-19 patients
October 14, 2021
The serum biomarker D-dimer trends can predict whether a COVID-19 patient's oxygen requirements will be worsening or improving compared to the day before.
BILOXI, MISSISSIPPI, UNITED STATES, October 14, 2021 /EINPresswire.com/ -- This is our pleasure to announce that Dr. Azad Kabir, MD MSPH (Biostatistics) found an inflammatory biomarker named D-dimer, which is readily available to all healthcare providers both outpatient and inpatient, can predict COVID-19 survival. The research titled “Anticoagulation is the answer in treating noncritical COVID-19 patients’' was published in the journal "Open Medicine"  on October 5th, 2021. The study was conducted using a chart review of COVID-19 patients admitted at Jackson Hospital Alabama, where Dr. Kabir works as a hospitalist under the department of Internal Medicine. The study also found that daily serum biomarker D-dimer trends (increasing or decreasing trends) can predict whether a COVID-19 patient's oxygen requirements will be worsening or improving compared to the day before. “Measuring serum D-dimer daily makes COVID-19 a very predictable disease,” said Dr. Kabir who is serving as a COVID-19 hospitalist since the start of the pandemic. The key to increased survival is to start a higher dose of anticoagulation upon diagnosis (early stage) of COVID-19 and titrate anticoagulation based on D-dimer trends, instead of stating therapeutic dose anticoagulation which increases the risk of bleeding. The recently published two clinical trials also found that high dose anticoagulation used in the early stages of COVID-19 improves patients' chance of survival when diagnosed with COVID-19.
The study abstract is listed below: “All autopsy studies demonstrated widespread thrombosis and alveolar-capillary microthrombi as the cause of death among patients with COVID-19. The autopsy studies are the gold standard for diagnostic accuracy and therapeutic strategies for any clinical scenario. The author initially observed that patients already taking therapeutic doses of oral direct factor Xa inhibitors for an unrelated reason, have significantly better survival rates than those not taking any anticoagulants. This influenced the author to conduct a retrospective chart review of the hospitalized patients in Jackson Hospital (Alabama) to evaluate the effect of variable doses of anticoagulation among COVID-19 patients. The study found that serum inflammatory biomarker D-dimer trends are associated with changes in oxygen requirement among patients with COVID-19, if patients present at an early stage, and titration of Enoxaparin (anticoagulation) dose based on D-dimer trends leads to increased patient survival.” One of the possible reasons behind the increased mortality among obese patients with COVID-19 is that they are getting a comparatively lower dose of Enoxaparin (a weight-dependent drug and is used at a prophylactic dose when anyone is admitted to the hospitals to prevent DVT) than they need to survive COVID-19 when admitted to the hospital.
Dr. Azad Kabir, founder, and CEO of Doctor Ai LLC recommends all patients with symptoms of COVID-19 seek health care from a physician's office, hospital, or any healthcare facility as soon as symptoms of COVID-19 are noticed so that anticoagulation can be considered as a treatment option. It is important to remember that seeking hospital care in a delayed stage will decrease the chance of survival due to COVID-19. “A simple test like daily D-dimer trends can predict survival, daily oxygen requirements, and your outcome can be improved if treated with a high dose of anticoagulation at an early stage of COVID-19 diagnosis,” said Dr. Kabir. The author recommends that healthcare providers should assess the risk of bleeding and discuss the risk with patients and family members before starting a higher dose of anticoagulation for COVID-19 treatments.
1. Kabir, Azad A.. "Anticoagulation is the answer in treating noncritical COVID-19 patients" Open Medicine, vol. 16, no. 1, 2021, pp. 1486-1492. https://doi.org/10.1515/med-2021-0354 https://www.degruyter.com/document/doi/10.1515/med-2021-0354