Use of Tranexamic Acid in SARS-COV-2: Boon or Bane?

Abstract

Tranexamic acid (TXA) is an antifibrinolytic agent commonly used for the treatment or prevention of bleeding. Indications for TXA are diverse, including heavy menstrual bleeding, trauma, postpartum hemorrhage, traumatic brain injury, and surgical site bleeding. Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. Older people and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illness. Anyone can get sick with COVID-19 and become seriously ill or die at any age. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2 or COVID-19) originated in Wuhan, China has spread at an alarming pace throughout the world and declared as a pandemic by the World Health Organization. The air droplet spread of SARS-CoV2 which is potentially fatal is of great global health concern. Various drugs and treatment modalities have been tried to date but none has been found to be definitive. Tranexamic acid commonly used in pigmentary disorders in Dermatology due to its ability to reduce the melanocyte tyrosinase activity also possesses anti-fibrinolytic and anti-inflammatory properties which have been observed to suppress the cytokine storm and modulate coagulopathy in patients suffering from COVID19. Tranexamic acid when administered early has been effective in decreasing the severity of symptoms in patients of COVID-19 but on the contrary, has also been associated with life-threatening thrombosis if given as a single drug.