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Fed up with covid articles...


Externet
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At the beginning, about every health related person had an opinion on how to cure the pandemic.  I stopped reading all claims that crossed in front of me.

By chance, another came in front of me yesterday that decided to read, claiming deaths are caused by lung trombosis; and that treatment ought to be blood thinners and not the way it has been done so far.

Occurs to me that a good probing method would be to count how many have died while being on blood thinning medication.  Is there such a statistic that can be evaluated ?   I have been on such medication for a few years after a coronaries procedure and had no covid symptoms at all while living a nearly unrestricted life.

 

-Please do not bury all related posts into one megathread-

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I doubt that folks in the field have firm ideas on how to cure the disease at best there are treatment options to improve outcome. Also the cure for pandemic has been the same as forever: reducing spread by isolation and other means, a measure that many failed to take, btw. 

The virus seems to wreck havoc on several levels, disruption of the coagulation cascades seems to be one of them. There seems to be two questions here, one whether blood thinner can reduce or prevent deaths and the second whether it can prevent symptoms. The latter is highly unlikely (to my knowledge) as many symptoms are unrelated to blood clotting in the first place (or rather, hyperactivation of the complement cascade, which might cause the coagulation, is one of the downstream effects of a virus-induced dysfunction). 

The former, however, is far more likely. There have been a number of studies looking at that. In best cases, treatment with anticoagulants improved survival (in cohort studies roughly 20% higher survival rate). In others only the most severely sick ill people seemed to benefit (though they also reported major bleeding in some patients). None of these are randomized trials so evidence level is somewhat low. It is possible that stronger treatments could improve the outcome further, and there are ongoing trials. Fundamentally it appears that some folks do benefit from it more than others.

If the assumption is whether folks taking blood thinners will not get sick at all then all I can say is there is zero evidence nor mechanism for that.

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8 minutes ago, Externet said:

Thank you.    Does the above mean coagulation is promoted or deterred ?

It is a bit complicated and I have not looked at it too deeply. However, one model is that the the inflammation might, similar to e.g. autoimmune diseases cause an activation of the complement cascade. This system is part of the immune system, but it interacts with the coagulation cascade (which does the clotting). There is evidence from other diseases that both system can enhance each other, and there is evidence that in COVID-19 patients that might lead to hypercoagulation and thrombosis (especially high D-dimer values, which are a produced by degradation of blood clots have been associated with poor outcomes).

So the short version is, there is evidence for increased blood clotting in certain patients. I should add that I with disruption I do not mean that the system is dysfunctional, rather that its normal functions are distorted.

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