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The impact of asprin use on the outcome of patients admitted to the intensive care unit with COVID-19 infection

Aidouni et al., Research Square, doi:10.21203/rs.3.rs-2313880/v1
Nov 2022  
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Mortality 31% Improvement Relative Risk Ventilation 10% Aspirin for COVID-19  Aidouni et al.  ICU PATIENTS Is very late treatment with aspirin beneficial for COVID-19? Prospective study of 1,124 patients in Morocco (Mar 2020 - Mar 2022) Lower mortality with aspirin (p=0.003) c19early.org Aidouni et al., Research Square, November 2022 Favorsaspirin Favorscontrol 0 0.5 1 1.5 2+
Prospective study of 1,124 COVID-19 ICU patients, showing lower mortality with aspirin treatment.
risk of death, 30.9% lower, HR 0.69, p = 0.003, treatment 202 of 712 (28.4%), control 165 of 412 (40.0%), NNT 8.6, adjusted per study, multivariable, Cox proportional hazards.
risk of mechanical ventilation, 9.6% lower, RR 0.90, p = 0.33, treatment 189 of 712 (26.5%), control 121 of 412 (29.4%), NNT 35.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Aidouni et al., 30 Nov 2022, prospective, Morocco, preprint, mean age 64.0, 6 authors, study period March 2020 - March 2022. Contact: aminbouchlarhem63@gmail.com.
This PaperAspirinAll
The impact of asprin use on the outcome of patients admitted to the intensive care unit with COVID-19 infection
Ghizlane El Aidouni, Amine Bouchlarhem, Houssam Bkiyar, Nabila Ismaili, Noha El Ouafi, Brahim Housni
doi:10.21203/rs.3.rs-2313880/v1
Background Our objective in this study is to know the impact of the use of asprin in anti-aggregation dose on the evolution during hospitalization of patients admitted in intensive care unit for a severe infection by SARS-COV-2. Methods We conducted a prospective study of patients admitted to our department with severe COVID-19 infection during the period between March 2020 and March 2022, analyzing the difference between the placebo group and the aspirin group on the primary endpoint of all-cause hospital mortality and the composite secondary endpoint of use of mechanical ventilation and thromboembolic events. Results Out of 1124 patients included, 32.6% died, with a protective effect of aspirin against placebo (Hazardratio = 0.691, p = 0.003), for thrombo-embolic complications, 104 events were observed, with a protective effect of aspirin (Hazard-Ratio = 0.448 and p = 0.001), nally regarding mechanical ventilation, there was no remarkable bene t on our sample. Conclusion Given the divergence of results of studies published in the literature, the availability of results of large randomized controlled trials is a necessity.
References
Abani, Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial, Lancet, doi:10.1016/S0140-6736(21)01825-0
Ahmed, Rationales and uncertainties for aspirin use in COVID-19: A narrative review, Fam. Med. Community Heal, doi:10.1136/fmch-2020-000741
Ali, Spinler, COVID-19 and thrombosis: From bench to bedside, Trends Cardiovasc. Med, doi:10.1016/j.tcm.2020.12.004
Birnhuber, Between in ammation and thrombosis: endothelial cells in COVID-19, The European respiratory journal, doi:10.1183/13993003.00377-2021
Botton, No association of low-dose aspirin with severe COVID-19 in France: A cohort of 31.1 million people without cardiovascular disease, Res. Pract. Thromb. Haemost, doi:10.1002/rth2.12743
Carbonell, COVID-19 and thromboprophylaxis: Recommendations for our clinical practice in Primary Care, Semergen, doi:10.1016/j.semerg.2020.07.007
Dzeshka, Shantsila, Lip, Effects of Aspirin on Endothelial Function and Hypertension, Curr. Hypertens. Rep, doi:10.1007/s11906-016-0688-8
Formiga, Does admission acetylsalicylic acid uptake in hospitalized COVID-19 patients have a protective role? Data from the Spanish SEMI-COVID-19 Registry, Intern. Emerg. Med, doi:10.1007/s11739-021-02870-1
Glatthaar-Saalmüller, Mair, Saalmüller, Antiviral activity of aspirin against RNA viruses of the respiratory tract-an in vitro study, uenza Other Respi. Viruses, doi:10.1111/irv.12421
Gómez-Mesa, Galindo-Coral, Montes, Muñoz Martin, Thrombosis and Coagulopathy in COVID-19, Curr. Probl. Cardiol, doi:10.1016/j.cpcardiol.2020.100742
Ma, Does aspirin have an effect on risk of death in patients with COVID-19? A metaanalysis, Eur. J. Clin. Pharmacol, doi:10.1007/s00228-022-03356-5
Moschonas, Tselepis, SARS-CoV-2 infection and thrombotic complications: a narrative review, J. Thromb. Thrombolysis, doi:10.1007/s11239-020-02374-3
Sahai, Effect of aspirin on short-term outcomes in hospitalized patients with COVID-19, Vasc. Med. (United Kingdom), doi:10.1177/1358863X211012754
Salah, Mehta, Meta-Analysis of the Effect of Aspirin on Mortality in COVID-19, The American journal of cardiology, doi:10.1016/j.amjcard.2020.12.073
Talasaz, Recent Randomized Trials of Antithrombotic Therapy for Patients With COVID-19: JACC State-of-the-Art Review, J. Am. Coll. Cardiol, doi:10.1016/j.jacc.2021.02.035
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Late treatment
is less effective
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