Published: 28 November 2022
A UK-wide trial has found that a drug used to reduce the risk of blood clots does not help patients recovering from moderate and severe COVID-19.
The HEAL-COVID trial (HElping to Alleviate the Longer-term consequences of COVID-19) is funded by the National Institute for Health and Care Research (NIHR) and the Cambridge NIHR Biomedical Research Centre.
More than 1,000 patients hospitalised with COVID-19 took part in the study, which is led by Cambridge University Hospitals NHS Foundation Trust (CUH) and the University of Cambridge.
The platform trial is aiming to find treatments to reduce the number who die or are readmitted following their time in hospital. Patients are asked to take part in the study when they are discharged from hospital, following their first admission for COVID-19. They are randomised to a treatment and their progress tracked.
Results have shown that prescribing Apixaban, an oral anticoagulant, does not stop coronavirus patients from later dying or being readmitted to hospital over the following year.
In addition to not being beneficial, a number of participants receiving Apixban experienced bleeding, requiring them to discontinue treatment.
There was also no benefit from Apixaban in terms of the number of days alive and out of hospital 60 days after starting the study (Apixaban 59 days, versus standard care 59 days).
Following these results, the trial will continue to test another drug called Atorvastatin. This is a widely used lipid lowering drug (‘a statin’) that acts on other mechanisms of disease that are thought to be important in COVID-19.
Professor Charlotte Summers, Chief Investigator for the trial and Intensive Care Specialist at Addenbrooke’s Hospital and the University of Cambridge, said: “Having survived the ordeal of being hospitalised with COVID-19, far too many patients find themselves back in hospital, often developing longer-term complications as a result of the virus.
“There is an urgent need for us to find treatments that prevent this significant burden of illness and improve the lives of so many still being affected by COVID-19.
“These first findings from HEAL-COVID show us that a blood thinning drug, commonly thought to be a useful intervention in the post-hospital phase is actually ineffective at stopping people dying or being readmitted to hospital. This finding is important because it will prevent unnecessary harm occurring to people for no benefit. It also means we must continue our search for therapies that improve longer term recovery for this devastating disease.”
Professor Nick Lemoine, NIHR Clinical Research Network Medical Director, said: "Research into COVID-19 recovery remains vital as we move out of the pandemic. Results such as these from the HEAL-COVID study, help to strengthen our knowledge of how patients can be treated following their stay in hospital and how recovery rates can be improved upon. Findings from clinical trials, whether they identify new treatments or rule out methods of care, are vital and rigorous evidence when it comes to changing best medical practice."
Dr Mark Toshner, joint Chief Investigator for HEAL-COVID, said: “Up until now it’s been assumed that Apixaban helps patients recover after severe COVID-19 and that thinning their blood to prevent clots is beneficial. This trial is the first robust evidence that longer anticoagulation after acute COVID-19 puts patients at risk for no clear benefit.
“Our hope is that these results will stop this drug being needlessly prescribed to patients with COVID-19 and we can change medical practice. Finding out that a treatment doesn’t work is really important. It’s not the solution many hoped it would be, with our results highlighting once again why testing treatments in randomised trials is important.”
More information about the HEAL-COVID trial can be found on the study website.