Bivalirudin (“Angiomax”): Rescue Therapy in Covid Cases

Given the low platelet counts in patients with blood clots arising from Heparin-induced thrombocytopenia (HIT)  in severe COVID191 or clots induced by Ad26.COV2.S vaccination, heparin is not a viable treatment. Alternative thrombin inhibitors are often sought out. Bivalrudin is a 20-residue peptide derived from the saliva of the leech and is a specific, reversible, direct thrombin inhibitor and an effective anticoagulant.  In a journal pre-proof in The Annals of Emergency Medicine, doctors describe the recent successful use of bivalirudin:

Early Outcomes of Bivalirudin Therapy for Thrombotic Thrombocytopenia and Cerebral Venous Sinus Thrombosis after Ad26.COV2.S Vaccination: A Case Report

https://www.annemergmed.com/pb/assets/raw/Health%20Advance/journals/ymem/YMEM_2021-969.pdf

It has also been reported to successfully to manage severe hypoxemic and hypercarbic respiratory failure requiring Venovenous Extracorporeal Membrane Oxygenation:

Bivalirudin for Maintenance Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation for COVID-19

https://linkinghub.elsevier.com/retrieve/pii/S1053077020306017

bivalirudin

Additional Reference:

  1. Heparin-Induced Thrombocytopenia in Severe COVID-19

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049015

Read more about the peptide bivalirudin:

https://www.ambiopharm.com/articles/bivalirudin/