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Impact of prior use of antiplatelets on COVID-19 susceptibility, progression, and severity: a population-based study
Ángela Prieto-Campo1, Maruxa Zapata-Cachafeiro2, Manuel Portela-Romero3
1Departamento de Salud Pública, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Insights
Triflusal use may increase COVID-19 infection risk and hospitalization, while aspirin may decrease susceptibility. This suggests reconsidering triflusal prescriptions during the COVID-19 pandemic.
Area of Science:
- Infectious Diseases
- Pharmacology
- Public Health
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes hypercoagulability and thromboembolism, contributing to COVID-19 morbidity and mortality.
- Antiplatelet drugs are commonly used, but their impact on COVID-19 outcomes requires further investigation.
Purpose of the Study:
- To evaluate the effect of antiplatelet drugs on COVID-19 severity, including hospitalization and mortality risk.
- To assess the influence of antiplatelet agents on susceptibility to SARS-CoV-2 infection and disease progression.
Main Methods:
- A population-based case-control study was conducted in Spain in 2020.
- The study included 3060 hospitalized COVID-19 patients, 26,757 non-hospitalized COVID-19 patients, and 56,785 healthy controls.
Main Results:
- Triflusal use was linked to a significant increase in hospitalization risk (aOR, 1.97) and infection susceptibility (OR, 1.45).
- Aspirin use was associated with a statistically significant decrease in susceptibility to SARS-CoV-2 infection (OR, 0.92).
- Triflusal showed a nonsignificant increase in mortality and disease progression risks.
Conclusions:
- Triflusal prescription may elevate the risk of COVID-19 infection and hospitalization.
- Other antiplatelet drugs, such as aspirin, might reduce infection risk or have no significant impact.
- Findings suggest a need to reconsider triflusal use during the COVID-19 pandemic.
Introduction And Objectives:
Hypercoagulability and thromboembolism are processes that arise from severe acute respiratory syndrome coronavirus 2 infection and are responsible for a high degree of coronavirus disease 2019 (COVID-19)-related morbidity and mortality. This study sought to assess the effect of antiplatelet drugs on COVID-19 severity (risk of hospitalization and mortality), susceptibility to severe acute respiratory syndrome coronavirus 2 infection, and progression to severe COVID-19.
Methods:
We conducted a population-based case-control study in a northwestern region of Spain in 2020. The study involved 3060 participants with a positive polymerase chain reaction test who were hospitalized, 26 757 participants with a positive polymerase chain reaction test who were not hospitalized, and 56 785 healthy controls.
Results:
Triflusal seemed to be associated with a significant increase in risk of hospitalization (aOR, 1.97; 95%CI, 1.27-3.04) and susceptibility to infection (OR, 1.45; 95%CI, 1.07-1.96). It also appeared to lead to a nonsignificant increase in the risk of mortality (OR, 2.23; 95%CI, 0.89-5.55) and/or progression to more severe disease stages (OR, 1.42; 95%CI, 0.8-2.51). Aspirin seemed to be associated with a statistically significant decrease in susceptibility to severe acute respiratory syndrome coronavirus 2 infection (OR, 0.92; 95%CI, 0.86-0.98).
Conclusions:
Triflusal use appears to increase the risk of susceptibility to COVID-19 infection and an even higher risk of hospitalization, whereas the other antiplatelets could be associated with a reduction in the risk of the various outcomes or have no effect on risk. These findings could support reconsideration of triflusal prescription in COVID-19 pandemic situations.
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