Because blood clotting can be one of the consequences of covid-19, it is especially dangerous for people with thrombosis or a high risk of thrombosis. According to a new guideline, if corona infection occurs, they are eligible to receive preventive blood thinners. General practitioner and researcher at UMC Utrecht Geert-Jan Geersing co-authored the guideline. The NOS published the article below about it.
For the first time general practitioners will prescribe medication to risk groups to prevent the serious consequences of a covid-19 infection. These are people at high risk of thrombosis and corona infection or suspected corona. They may be given preventive blood thinners.
The eligible groups are people with a thrombosis condition (had previous thrombosis or a lot of thrombosis in the family) or for people with cancer. That adds up to about 150 to 200 thousand people a year. The measure to prescribe blood thinners to these groups in case of a (possible) coronary infection is included in a new guideline for general practitioners.
Thrombosis is the development of clots in blood vessels and a serious and often life-threatening consequence of covid-19 infection in a proportion of patients. In the intensive care unit, half of the patients have thrombosis. With the preventive administration of blood thinners, the group may no longer need to be hospitalized.
The type of blood thinner administered to the thrombosis groups is by injection. It is not the same blood thinner that cardiovascular disease patients receive (so-called platelet inhibitors, such as aspirin). Further research is underway on whether preventive prescription of blood thinners can work for other groups, such as the large group of people with cardiovascular disease.
“Here we are talking about the beginning of a treatment against the complications of corona,” says Geert-Jan Geersing, family physician, researcher at UMC Utrecht and coauthor of the guideline. “There is a lot we don’t know about what the corona virus does. But the relationship with thrombosis is undeniable. That is why we now include in the guideline that general practitioners can already play an important role in preventing it.”
The guideline for GPs states that those at risk can be given a low dose of blood thinners daily, similar to the amount also given to people who have undergone hip surgery or after pregnancy. However, the persons receiving the medication must actually be ill.
There is also a downside to blood thinners, as it can lead to bleeding. A general practitioner will have to assess whether administering the drug is actually necessary in each individual patient.
Research in Dutch hospitals previously showed that many corona patients in the ICU develop thrombosis symptoms. As a result, they are more likely to die. High doses of blood thinners are now administered to all corona patients in the hospital.
Geersing: “To our knowledge, the Netherlands is the first country with special treatment advice for general practitioners aimed at preventing the serious consequences of the coronavirus in high-risk groups.”
