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Effect of Aspirin Use on the Adverse Outcomes in Patients Hospitalized for COVID-19
Poornima Vinod1,2, Vinod Krishnappa1, William Rathell1
1Department of Internal Medicine, University of North Carolina Health Southeastern, Lumberton, NC, USA.
Insights
Aspirin use in hospitalized COVID-19 patients showed no significant differences in major adverse events or mortality. However, aspirin users had shorter mechanical ventilation durations but longer hospital stays.
Area of Science:
- Cardiology
- Pulmonology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) is associated with significant inflammation and thrombotic events.
- Aspirin, with its anti-inflammatory and anti-thrombotic properties, was considered for COVID-19 treatment.
- Understanding aspirin's impact on COVID-19 outcomes is crucial for clinical management.
Purpose of the Study:
- To investigate the association between aspirin use and clinical outcomes in hospitalized COVID-19 patients.
- To evaluate the effect of aspirin on cardiovascular events, thrombosis, respiratory failure, and mortality.
Main Methods:
- Retrospective study of adult patients hospitalized with COVID-19 from March to October 2020.
- Primary outcomes included acute cardiovascular events and death.
- Secondary outcomes included respiratory failure, mechanical ventilation, and deep vein thrombosis/pulmonary embolism.
Main Results:
- No significant differences in mechanical ventilation, cardiovascular events, deep vein thrombosis/pulmonary embolism, or mortality between aspirin and non-aspirin groups.
- Aspirin users experienced significantly shorter median mechanical ventilation duration (7 vs. 9 days).
- Aspirin users had a significantly longer median length of hospitalization (5.5 vs. 4 days).
Conclusions:
- Aspirin use was not associated with significant differences in major adverse cardiovascular events, deep vein thrombosis/pulmonary embolism, or mortality in hospitalized COVID-19 patients.
- Further research with larger cohorts is needed to confirm these findings.
- Aspirin's role in managing COVID-19 requires continued investigation, considering potential impacts on ventilation and hospital stay duration.
Background:
Coronavirus disease 2019 (COVID-19) triggers multiple components of the immune system and causes inflammation of endothelial walls across vascular beds, resulting in respiratory failure, arterial and venous thrombosis, myocardial injury, and multi-organ failure leading to death. Early in the COVID-19 pandemic, aspirin was suggested for the treatment of symptomatic individuals, given its analgesic, antipyretic, anti-inflammatory, anti-thrombotic, and antiviral effects. This study aimed to evaluate the association of aspirin use with various clinical outcomes in patients hospitalized for COVID-19.
Methods:
This was a retrospective study involving patients aged ≥ 18 years and hospitalized for COVID-19 from March 2020 to October 2020. Primary outcomes were acute cardiovascular events (ST elevation myocardial infarction (STEMI), type 1 non-ST elevation myocardial infarction (NSTEMI), acute congestive heart failure (CHF), and acute stroke) and death. Secondary outcomes were respiratory failure, need for mechanical ventilation, and acute deep vein thrombosis (DVT)/pulmonary embolism (PE).
Results:
Of 376 patients hospitalized for COVID-19, 128 were taking aspirin. Significant proportions of native Americans were hospitalized for COVID-19 in both aspirin (22.7%) and non-aspirin (24.6%) groups. Between aspirin and non-aspirin groups, no significant differences were found with regard to mechanical ventilator support (21.1% vs. 15.3%, P = 0.16), acute cardiovascular events (7.8% vs. 5.2%, P = 0.32), acute DVT/PE (3.9% vs. 5.2%, P = 0.9), readmission rate (13.3% vs. 12.9%, P = 0.91) and mortality (23.4% vs. 20.2%, P = 0.5); however, the median duration of mechanical ventilation was significantly shorter (7 vs. 9 days, P = 0.04) and median length of hospitalization was significantly longer (5.5 vs. 4 days, P = 0.01) in aspirin group compared to non-aspirin group.
Conclusion:
No significant differences were found in acute cardiovascular events, acute DVT/PE, mechanical ventilator support, and mortality rate between hospitalized COVID-19 patients who were taking aspirin compared to those not taking aspirin. However, larger studies are required to confirm our findings.
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