COVID-19, Thrombosis and Patient Treatment and Care

In a recent BBC News report; “Coronavirus: a third of hospital patients develop dangerous blood clots” – Richard Galpin 16th May 2020, the fact that so little was known as to why so many patients with COVID-19 were also presenting with Thrombosis (DVT and Pulmonary Embolism). A recent paper published by the “Journal of Thrombosis and Haematosis” has some very interesting thoughts and conclusions.

https://onlinelibrary.wiley.com/doi/abs/10.1111/jth.14929

The paper looks at the treatment of COVID-19 patients whilst in the hospital environment, and the desired best practice for identification, treatment whilst in the NHS and care post discharge.

The cost to the NHS (just for treatment) for VTE (DVT (deep vein thrombosis) and PE (pulmonary embolism) at present is over £200,000,000 a year and rising. With the increase of patients presenting with deadly blood clots because of COVID-19, how much will this increase of a third of extra patients cost the NHS?

Patients discharged from hospital face further risk of developing a deadly blood clot up to 90 days post discharge. Patients are typically anticoagulated for 6 months post discharge.

Treatment is usually based around the administration of LWMH (Low Weight Molecular Heparin), a course of anticoagulants (Warfarin or a DOAC) and graduated compression stockings.

Problems however can and will be encountered, especially considering the typical age range of those affected by COVID-19.

  • LWMH needs to be administered by injection (once, twice a day)
  • Warfarin needs to be monitored, the patients INR (international normalised ratio) requires frequent blood tests
  • DOAC’s work quickly once taken, however, the effects wear off just as quickly, so medicine must be taking as directed

These points have to be considered. Where does the responsibility fall and to whom? The patient, the GP, Care Worker. All these elements add to the continued threat of the second wave being encountered, as isolation will not be truly possible.

A further matter that clinicians, GP’s, care workers must be aware of, is the recent paper published by Imperial College. The paper reviews the effectiveness of graduated compression stockings and their benefit of reducing the threat of the patient developing a DVT.  The conclusion of the paper states that GCS’s “make no difference to the risk of blood clots” and that “the risk of blood clots following surgery is the same whether patients wear compression stockings or not, a new trial has found”

19th May 2020 – https://www.imperial.nhs.uk/about-us/news/compression-stockings-unnecessary-following-surgery

For decades, Graduated Compression Stockings have been a constant aspect of patient care and treatment within the NHS and the wider medical sector. Whether post-surgery, in maternity, in ICU, or throughout long-term hospitalisation, the NHS has relied upon the GCS as a form of DVT prevention. At present the compression stockings market is substantial, valued at £1.6 billion in 2018, and expected to reach £2.4 billion by 2026.

Paul Westerman, Director of RBR Active™, says: “increasingly sedentary lifestyles have become a major cause of Deep Vein Thrombosis (DVT) and similar venous disorders. Every year, over 2 million deaths are attributable to a sedentary lifestyle. Whether we’re working from home more (as in the present COVID19 pandemic crisis); binge-watching Netflix box-sets or gaming on-line for hours, our sedentary lifestyles are quite literally killing us. As a preventive measure, people have been using compression garments, including compression socks, as a therapy or as a precautionary measure.”

“The recent paper by the Imperial College, is a game changer in the care and treatment of Thrombosis going forward. If we also now look at the threat of DVT presenting in a third of patients with COVID-19 we have opened a whole new area of vital long-term care for those affected by Thrombosis, and compression stockings now, are not a viable option.”

What does this mean going forward? 

RBR Active™ know that a proven solution is available now. The RBR Legflow™ created through the research of Professor Richard Beasley and his team at the MRINZ, increases blood flow to the lower limbs by over 10-fold. By supporting and increasing the body’s natural blood circulation the RBR Legflow™ greatly improves circulation and this is what is key to protecting yourself from developing a Deep Vein Thrombosis.

Paul says; “The research we’ve undertaken, the clinical trials that have been run, prove, that the RBR Legflow™ increases blood flow to the lower limbs, significantly reducing the threat of the patient developing a deadly blood clot. The medical device is approved by the MHRA, is made with an antimicrobial ingredient making it 99.9995% safe from cross infection. It’s quite simply an ideal and proven solution that needs to be used within the NHS.”

Key facts:

  • During sustained periods of immobility, like flying, the combined effects of venous pooling, reduced flow create the conditions necessary for thrombus activation
  • The cost of thrombosis to the NHS is estimated at over £200 million a year
  • Globally this is a cost to health service providers of more than £22 billion each year
  • More than 60% of all cases of VTE are associated with hospitalisation, with many events occurring up to 90 days after admission
  • VTE affects approximately one in 1000 of the UK population and is a significant cause of mortality, long-term disability and chronic ill-health problems
  • In Europe, there are 544,000 VTE-related deaths every year
  • In the U.S. and Europe, VTE-related events kill more people than AIDS, breast cancer, prostate cancer and motor vehicle crashes combined 
  • In the UK, up to 60% of VTE cases occur during or after hospitalisation, making it the leading preventable cause of hospital death 
  • Hospital-acquired blood clots cause an estimated 25,000 preventable deaths each year 
  • Made with an antimicrobial ingredient giving a 99.9995% protection from MRSA and E-Coli
  • Made in Britain

Risk Factors for DVT

Older Age                                Immobility                                          Obesity

Medical History                      Pregnancy                                           HRT

Surgery                                    Hospitalisation                                   Oral Contraceptives

Long-Haul Travel                     Cancer                                                 Trauma

For further information – please contact 

Paul Westerman         paul.westerman@rbractive.com

RBR Active™                 www.rbractive.com