Decreased In-Hospital Mortality Associated with Aspirin Administration in Hospitalized Patients Due to Severe COVID-19
Aghajani et al.,
Decreased In-Hospital Mortality Associated with Aspirin Administration in Hospitalized Patients Due to Severe..,
Journal of Medical Virology, doi:10.1002/jmv.27053
Retrospective 991 hospitalized patients in Iran focusing on aspirin use but also showing results for HCQ, remdesivir, and favipiravir.
[Gérard, Zhou] show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 18.6% lower, HR 0.81, p = 0.49, treatment 46, control 945, univariate Cox proportional regression.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Aghajani et al., 29 Apr 2021, retrospective, Iran, peer-reviewed, 7 authors.
Abstract: Received: 14 February 2021
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Revised: 17 April 2021
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Accepted: 26 April 2021
DOI: 10.1002/jmv.27053
RESEARCH ARTICLE
Decreased in‐hospital mortality associated with aspirin
administration in hospitalized patients due to severe
COVID‐19
Mohammad Haji Aghajani1 | Omid Moradi2
| Hossein Amini2 |
Hamed Azhdari Tehrani3 | Elham Pourheidar3 | Mohammad M. Rabiei4
|
1,5
Mohammad Sistanizad
1
Prevention of Cardiovascular Disease
Research Center, Imam Hossein Hospital,
Shahid Beheshti University of Medical
Sciences, Tehran, Iran
2
Department of Clinical Pharmacy, School of
Pharmacy, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
3
Department of Hematology and Medical
Oncology, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
4
Abstract
Hypercoagulability and thrombosis caused by coronavirus disease 2019 (COVID‐19)
are related to the higher mortality rate. Because of limited data on the antiplatelet
effect, we aimed to evaluate the impact of aspirin add‐on therapy on the outcome of
the patients hospitalized due to severe COVID‐19. In this cohort study, patients
with a confirmed diagnosis of severe COVID‐19 admitted to Imam Hossein Medical
Center, Tehran, Iran from March 2019 to July 2020 were included. Demographics
Clinical Research Development Unit of
Loghman Hakim Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran
and related clinical data during their hospitalization were recorded. The mortality
5
aspirin use was assessed. Nine hundred and ninety‐one patients were included, of
Department of Clinical Pharmacy, School of
Pharmacy, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
rate of the patients was considered as the primary outcome and its association with
that 336 patients (34%) received aspirin during their hospitalization and 655 ones
(66%) did not. Comorbidities were more prevalent in the patients who were re-
Correspondence
Mohammad Sistanizad, Department of
Clinical Pharmacy, School of Pharmacy,
Shahid Beheshti University of Medical
Sciences, Valiasr St, Tehran 14155‐6153, Iran.
Email: Sistanizadm@sbmu.ac.ir
ceiving aspirin. Results from the multivariate COX proportional model demonstrated a significant independent association between aspirin use and reduction
in the risk of in‐hospital mortality (0.746 [0.560–0.994], p = 0.046). Aspirin use
in hospitalized patients with COVID‐19 is associated with a significant decrease in
mortality rate. Further prospective randomized controlled trials are needed to assess the efficacy and adverse effects of aspirin administration in this population.
KEYWORDS
aspirin, cohort study, COVID‐19, mortality, SARS coronaviruses, thromboembolism
1
| INTRODUCTION
despite using pharmacological thromboprophylaxis.1,2,5 The benefit
of using the anticoagulant to decrease the risk of these complications
From the beginning of the coronavirus disease 2019 (COVID‐19)
and improve the survival of the patients with COVID‐19 was con-
pandemic, different aspects of the disease pathology have been
firmed by many studies3,6,7 but data about the effect of antiplatelet
reported. Studies showed the significant effect of COVID‐19 on
agents on these complications are limited.2,7 Aspirin has been com-
increasing the risk of hypercoagulability and thrombosis that are
monly recommended for the primary prevention of atherosclerotic
associated with increased mortality.1–4 Although the incidence rate
cardiovascular diseases in high‐risk..
Late treatment
is less effective
aghajani
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