Injections in the abdomen with coronavirus and why they are prescribed

Blood clotting problems in COVID-19

Studies show that blood clotting disorders, especially in the pulmonary vessels, can accompany coronavirus infection and contribute to the severe course of COVID-19. What's more, elevated blood D-dimer levels are associated with a poor prognosis in coronavirus patients.

D-dimers are a breakdown product of blood clots, and their increased level indicates the presence of venous thrombosis.

Autopsy findings from patients who died from COVID-19 show the presence of intravascular coagulation sites in the small vessels of the lungs and concomitant tissue necrosis. More and more data also show that in complicated cases, the risk of venous thrombosis and pulmonary embolism increases, which significantly increases the likelihood of death.

Patients with COVID-19 also experience heart attacks and strokes associated with blood clots. Thus, anticoagulants are necessary for patients with coronavirus who are at risk of thrombus formation. These drugs provide effective prevention of complications in the circulatory system.

What are the anticoagulants?

Many factors are responsible for blood clotting and clot breakdown. Both processes occur simultaneously, creating a balance that ensures free blood flow and at the same time stops bleeding in case of damage to the vessel. This process is called hemostasis. There are also several classes of anticoagulants that differ in their mechanism of action.

These include:

Heparin - a natural anticoagulant produced in the liver, it is administered subcutaneously or intravenously, although there are gels for application to the skin;
factor Xa inhibitors - Rivaroxaban, Apixaban, Edoxaban (sold under the names Xarelto, Eliquis);
vitamin K antagonists - Acenocoumarol and Warfarin, they block the production of important coagulation factors in the liver;
direct thrombin inhibitors - Dabigatran (Pradaxa).

With coronavirus, various drugs can be prescribed that are classified as anticoagulants, at the discretion of a specialist.

Anticoagulant injections into the abdomen

By reducing blood clotting, anticoagulant injections help prevent venous thromboembolism in coronavirus. The pathology is manifested by deep vein thrombosis of the legs or arms or life-threatening acute pulmonary embolism.

The drugs are used as subcutaneous injections. Blood thinning shots include Heparin and derivatives. Low molecular weight heparins can also be used, for example, Lovenox, Fragmin, Fraxiparin, Neoparin. These are prescription drugs.

Unfractionated heparins are mainly used by intravenous injection.

To select the correct dose of the drug, measure the APTT (activated partial thromboplastin time) in blood plasma after adding a kaolin-cephalin reagent and calcium chloride solution to it. Ultimately, it aims to achieve the index at the level of 1, 5-2, 5.

Low molecular weight heparins are selective, making them safer and more suitable for self-administration by patients. In this case, there is no need to check the APTT indicator. In addition, they last longer, so it is sufficient to inject them 1-2 times a day.

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Anticoagulant injections - indications for use in coronavirus

Heparins are the drugs of choice when immediate anticoagulant therapy is required. They are used to prevent and treat venous thromboembolism and to treat venous thrombosis as potential complications of coronavirus. In addition, unfractionated heparin infusions are also used for the early treatment of people with acute myocardial infarction or acute pulmonary embolism.

Patients have many doubts about the need for injections of anticoagulants. Many of them do not understand why injections are prescribed specifically in the abdomen, and not in some other.

Circulatory problems are now quite common among people who are in the hospital due to coronavirus or after being discharged from the ward. In some situations, the risk of such a complication can be up to 80%. The problem is that with coronavirus, the disease initially goes away without symptoms, and suddenly a life-threatening pulmonary embolism can appear.

The use of anticoagulant prophylaxis through injections in the abdomen with coronavirus significantly reduces the risk of complications in patients. In addition to injections, early mobilization of patients in bed, physical therapy and proper hydration are very important.

Oral anticoagulants are also used, but in their case it takes longer to select the appropriate dose and obtain a therapeutic effect. The use of Heparin for prophylaxis is recommended in the absence of contraindications for people with risk factors:

with significant obesity;
in old age;
in the presence of venous thromboembolism in the past;
with prolonged immobilization, for example, after a fracture on a plaster cast or during long trips in a sitting position;
with a stroke leading to paresis;
with pneumonia;
in the case of thrombophilia and antiphospholipid syndrome.

Most injections are in the abdomen, but you can also use them in the thigh or shoulder. The attending physician chooses which drug should be prescribed to the patient.

Outcomes

An injection of anticoagulants for coronavirus into the abdomen is necessary to prevent complications with blood clotting.
The decision on the appointment remains with the medical staff, as well as the choice of the appropriate medication.
Almost always, such procedures are prescribed to people who are at risk. For example, these are persons with a history of venous thromboembolism and other complications.