Blood pressure drugs linked to lower death risk; more sensitive test recommended for blood clot risk
By Nancy Lapid
(Reuters) - The following is a brief roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.
Taking blood pressure medicines linked to lower COVID-19 mortality
Regularly taking drugs to control high blood pressure appears to lower the risk of becoming severely ill or dying if people with hypertension become infected with the new coronavirus, a new study found. Among nearly 2,900 people hospitalized in China with COVID-19, patients with high blood pressure had twice the risk of death and were more likely to need mechanical ventilation than those without hypertension, a known risk factor for severe COVID-19. But those taking drugs to control their blood pressure had a significantly lower risk of death from COVID-19 than those not treated for their hypertension, researchers reported on Thursday in the European Heart Journal. This was true even if patients were taking blood pressure drugs known as ACE inhibitors or ARBs. Several papers have suggested these drugs might increase COVID-19 susceptibility, but in this study, "the results were in the opposite direction, with a trend in favor of ACE inhibitors and ARBs," said coauthor Fei Li of Xijing Hospital in Xi'an, China. The American College of Cardiology, American Heart Association and Heart Failure Society of America have all recommended that patients continue taking hypertension drugs prescribed to them. (https://bit.ly/3cDTwjH; https://reut.rs/2MxVQy6;)
More precise test recommended to predict blood clots in severe COVID-19 patients
Standard tests performed in intensive care units (ICUs) to assess blood clotting risk in COVID-19 patients have been less than optimal, with catheters in veins and arteries frequently - and unpredictably - becoming clogged by blood clots. Heart surgeons in Texas, hearing of the problem, suggested use of a thromboelastography (TEG) test, which looks at how quickly a clot forms, as well as its strength and stability. TEG is used most often for open heart surgery and trauma patients. When the Texas doctors studied 21 ICU patients with COVID-19, almost two-thirds had developed clots that could be predicted by the TEG test, but not by standard tests, according to a report on Friday in JAMA Network Open. "The TEG test should be performed on all COVID-19 ICU patients immediately to find those who are at a higher risk of clotting," study coauthor Dr. Todd Rosengart, chair of the DeBakey department of surgery at Baylor College of Medicine in Houston, said in a statement. By the time catheters are clotting, "the horse is out of the barn," he said. For patients at higher risk of blood clots as indicated by the TEG test, the researchers recommend use of additional blood thinners. (https://bit.ly/2Buzf34)
Less invasive, self-performed swab tests may be as good as tests done by healthcare workers
When people with upper respiratory symptoms need to be tested for the coronavirus, having them swab the inside of their nose might be just as effective as having a healthcare worker collect nasopharyngeal samples, researchers suggested on Wednesday in The New England Journal of Medicine. At outpatient clinics in the Puget Sound region of Washington state, 530 patients collected samples from the tongue and from two places inside the nose. A nasopharyngeal sample was also obtained by a healthcare worker. As it turned out, nose samples collected by the patients were more than 90% accurate at identifying coronavirus infections. If these early results could be verified in larger studies with broader populations, the researchers said, self-swabbing of the nose would be more comfortable for patients and safer for the healthcare workers who would have less exposure to aerosolized virus droplets and would require less personal protective equipment. (https://bit.ly/2UbjPan)
Retracted studies shine harsh light on respected journals
Two of the world's most highly respected medical journals - The Lancet and The New England Journal of Medicine - on Thursday withdrew papers written by the same team of authors about COVID-19 treatments, citing concerns about the data. The high-profile Lancet paper had reported treating COVID-19 with hydroxychloroquine increased the risk of death, based on an observational review of 96,000 patients worldwide. That finding led the World Health Organization and others to halt major trials. Other researchers quickly questioned whether data on so many patients could have been collected and analyzed in the short time since the pandemic began. When Surgisphere, the company that provided the data for both studies, refused to transfer its dataset for independent review, several of the authors said they can no longer vouch for its veracity. "Science will not move forward if others can't check researchers' work. The need for speed is no excuse," said Dr. Ivan Oransky, vice president of Medscape and co-founder of the Retraction Watch blog. The recent events are "also a reminder that policy U-turns based on a single study are almost always a bad idea," Oransky told Reuters. (https://reut.rs/2Y663qJ;)
(Reporting by Nancy Lapid, Saumya Joseph and Michael Erman; Editing by Bill Berkrot)
