The AustralaSian COVID-19 Trial (ASCOT) has pinpointed the most efficient level of blood thinning treatment needed for patients hospitalised with COVID-19, in a study published in the New England Journal of Medicine Evidence and presented at the American Society for Hematology conference.

Patients in hospital with COVID-19 are at increased risk of blood clots (or thromboses), which in turn may contribute to development of organ failure. Almost all these patients will receive some degree of blood thinning medication.

In an international study, the ASCOT team conducted a randomised clinical trial to test different levels of anticoagulation (or blood thinning) in more than 1,500 patients in Australia, New Zealand, India and Nepal.

They found that an intermediate level of anticoagulation had an 86% probability of being better than low dose anticoagulation. A higher therapeutic dose did not show any benefit.

Anticoagulant use is recommended in all guidelines including in India but the most effective and safest dose is not known. This trial was done to find out the dose that provided the most benefit at the lowest risk. This trial is especially relevant to India as 1273 out of 1526 participants were recruited in Indian hospitals. 

According to Professor Vivekanand Jha, Executive Director at The George Institute for Global Health, India, “Even as the case numbers were low in Australia and New Zealand, existing network relationships allowed us to take the trial to India and Nepal, where COVID-19 was active and successfully complete this study that asks a question of global relevance. The rapid subject recruitment during the difficult time of the delta wave is a testimony to the commitment of site investigators and study staff in these centres.”