NEW DELHI: Alarmed by reports of even mildly or moderately sick COVID-19 patients suddenly collapsing after developing a relatively less understood complication related to the infection -- clotting of blood which then hampers vital organs -- several hospitals in India have started giving them blood thinners.
The practice of giving anticoagulants to hospitalised COVID-19 patients has started even though the ICMR's national guidelines on clinical management of the coronavirus are still silent on this aspect.
Several clinicians treating coronavirus patients told this correspondent that this complication is increasingly being recognized as a major challenge mainly in Western countries such as the US, UK and Italy where clinical records of a large number of patients are being recorded vigorously.
“Autopsies were conducted on several victims of COVID-19 in Italy and it was found that their lungs, kidneys or brains were badly clogged,” said Dr Yatin Mehta, head of the critical care department at Medanta hospital in Gurugram where a number of coronavirus patients have been treated.
“We are giving an anti-coagulant drug to coronavirus patients as our treatment plan and in my view all patients with this infection who need hospital care should be given this drug,” he said.
The treatment guidelines for COVID-19 in AIIMS, Delhi which is also running a call centre guiding doctors across India on treating infected patients, were also revised last week to include a drug for thromboprophylaxis -- or preventing clotting of blood -- for anyone who gets hospitalised with the disease.
While respiratory issues and pneumonia in severe cases are one of the key symptoms of infections, other complications like kidney issues and heart problems are also being noticed in patients. Doctors are also seeing blood clots in lungs and bodies of patients in up to 40 per cent of all cases -- indicating that a lot more needs to be fully understood about the disease.
And while the unexpected symptoms like clotting of blood themselves are posing a challenge, an even bigger issue for clinicians is how to treat patients in the absence of any guidelines on evidence-based treatment.
“Anti-coagulants are being used in COVID-19 patients in India based on the clinical judgment of treating doctors but there is not enough clarity on what dose is appropriate in what condition,” said Dr Anupam Singh, a specialist in internal medicine at Santosh Institute of Medical Sciences in Ghaziabad.