tPA for Critically Ill ICU Patients with COVID-19: Does Alteplase Help?

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COVID-19

How do you define a last-ditch effort to save someone’s life from COVID-19? Perhaps giving tPA to a severe COVID patient? At this point, I am certain many of us have attempted, with informed consent of course, therapies for our patients that may make theoretical sense but have no evidence to support its use.

At the beginning of the pandemic, we understood the hypercoagulability that we were seeing in our patients.

The pulmonary emboli, the DVT’s, the d-dimers that were through the roof.

For those of us who checked a plethora of labs daily attempting to understand what we were dealing with at the beginning, we noted that there was a correlation between an increasing d-dimer and severity of illness in many patients.

As data came out, we realized we were correct in autopsies showing disseminated pulmonary microvascular thrombosis.

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