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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 47% Improvement Relative Risk Ventilation 44% ICU admission 43% Aspirin for COVID-19  Chow et al.  LATE TREATMENT Is late treatment with aspirin beneficial for COVID-19? Retrospective 412 patients in the USA Lower mortality (p=0.02) and ventilation (p=0.007) with aspirin c19early.org Chow et al., Anesthesia & Analgesia, Apr 2021 Favors aspirin Favors control

Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019

Chow et al., Anesthesia & Analgesia, doi:10.1213/ANE.0000000000005292
Apr 2021  
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Aspirin for COVID-19
19th treatment shown to reduce risk in March 2021
 
*, now known with p = 0.000061 from 71 studies, recognized in 2 countries.
Lower risk for mortality and progression.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments. c19early.org
Retrospective 412 hospitalized patients, 98 treated with aspirin, showing lower mortality, ventilation, and ICU admission with treatment.
risk of death, 47.0% lower, HR 0.53, p = 0.02, treatment 26 of 98 (26.5%), control 73 of 314 (23.2%), adjusted per study, Cox proportional hazards.
risk of mechanical ventilation, 44.0% lower, HR 0.56, p = 0.007, treatment 35 of 98 (35.7%), control 152 of 314 (48.4%), NNT 7.9, adjusted per study, Cox proportional hazards.
risk of ICU admission, 43.0% lower, HR 0.57, p = 0.007, treatment 38 of 98 (38.8%), control 160 of 314 (51.0%), NNT 8.2, adjusted per study, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chow et al., 1 Apr 2021, retrospective, USA, peer-reviewed, 38 authors.
This PaperAspirinAll
Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019
MD. Jonathan H Chow, MD, FCCP , FCCM, † ‡ Ashish K Khanna, MD. Shravan Kethireddy, MD. David Yamane, MD. Andrea Levine, MD,# Amanda M Jackson, MD. Michael T Mccurdy, MD. Ali Tabatabai, MD. Gagan Kumar, MD. Paul Park, RN, MPH Ivy Benjenk, MD. Jay Menaker, MD. Nayab Ahmed, MD,∥∥ Evan Glidewell, MD. Elizabeth Presutto, MD, ¶ ¶ Shannon Cain, BS Naeha Haridasa, MD Wesley Field, BS,∥∥ Jacob G Fowler, MD, † † Duy Trinh, BS,∥∥ Kathleen N Johnson, DO, § § Aman Kaur, BS Amanda Lee, MD,∥∥ Kyle Sebastian, MD, † † Allison Ulrich, MD Salvador Peña, PhD,∥∥ Ross Carpenter, MD, † † Shruti Sudhakar, MD. Pushpinder Uppal, MD, Capt, USAF, MC, † † Benjamin T Fedeles, MD, † † Aaron Sachs, MD. Layth Dahbour, MD. William Teeter, MD Kenichi Tanaka, DO, PhD. Samuel M Galvagno, MD. Daniel L Herr, MD. Thomas M Scalea, MD, MPH. Michael A Mazzeffi
Anesthesia & Analgesia, doi:10.1213/ane.0000000000005292
BACKGROUND: Coronavirus disease-2019 (COVID-19) is associated with hypercoagulability and increased thrombotic risk in critically ill patients. To our knowledge, no studies have evaluated whether aspirin use is associated with reduced risk of mechanical ventilation, intensive care unit (ICU) admission, and in-hospital mortality. METHODS: A retrospective, observational cohort study of adult patients admitted with COVID-19 to multiple hospitals in the United States between March 2020 and July 2020 was performed. The primary outcome was the need for mechanical ventilation. Secondary outcomes were ICU admission and in-hospital mortality. Adjusted hazard ratios (HRs) for study outcomes were calculated using Cox-proportional hazards models after adjustment for the effects of demographics and comorbid conditions. RESULTS: Four hundred twelve patients were included in the study. Three hundred fourteen patients (76.3%) did not receive aspirin, while 98 patients (23.7%) received aspirin within 24 hours of admission or 7 days before admission. Aspirin use had a crude association with less mechanical ventilation (35.7% aspirin versus 48.4% nonaspirin, P = .03) and ICU admission (38.8% aspirin versus 51.0% nonaspirin, P = .04), but no crude association with in-hospital mortality (26.5% aspirin versus 23.2% nonaspirin, P = .51). After adjusting for 8 confounding variables, aspirin use was independently associated with decreased risk of mechanical ventilation (adjusted HR, 0.56, 95% confidence interval [CI], 0.37-0.85, P = .007), ICU admission (adjusted HR, 0.57, 95% CI, 0.38-0.85, P = .005), and in-hospital mortality (adjusted HR, 0.53, 95% CI, 0.31-0.90, P = .02). There were no differences in major bleeding (P = .69) or overt thrombosis (P = .82) between aspirin users and nonaspirin users. CONCLUSIONS: Aspirin use may be associated with improved outcomes in hospitalized COVID-19 patients. However, a sufficiently powered randomized controlled trial is needed to assess whether a causal relationship exists between aspirin use and reduced lung injury and mortality in COVID-19 patients. (Anesth Analg 2021;132:930-41) KEY POINTS • Question: Is aspirin use associated with less mechanical ventilation in coronavirus disease-2019 (COVID-19) patients? • Findings: In an observational cohort study of 412 adult patients with COVID-19, aspirin use was associated with a significantly lower rate of mechanical ventilation, intensive care unit (ICU) admission, and in-hospital mortality after controlling for confounding variables. • Meaning: Aspirin may have lung-protective effects and reduce the need for mechanical ventilation, ICU admission, and in-hospital mortality in hospitalized COVID-19 patients.
References
Ackermann, Verleden, Kuehnel, Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19, N Engl J Med
Arnold, Parrillo, Dellinger, Point-ofcare assessment of microvascular blood flow in critically ill patients, Intensive Care Med
Bjornsson, Schneider, Berger, Aspirin acetylates fibrinogen and enhances fibrinolysis. Fibrinolytic effect is independent of changes in plasminogen activator levels, J Pharmacol Exp Ther
Bowman, Mafham, Stevens, ASCEND: a study of cardiovascular events in diabetes: characteristics of a randomized trial of aspirin and of omega-3 fatty acid supplementation in 15,480 people with diabetes, Am Heart J
Boyle, Gangi, Hamid, Aspirin therapy in patients with acute respiratory distress syndrome (ARDS) is associated with reduced intensive care unit mortality: a prospective analysis, Crit Care
Chen, Janz, Bastarache, Prehospital aspirin use is associated with reduced risk of acute respiratory distress syndrome in critically ill patients: a propensityadjusted analysis, Crit Care Med
Cui, Chen, Li, Liu, Wang, Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia, J Thromb Haemost
Eikelboom, Hirsh, Spencer, Baglin, Weitz, Antiplatelet drugs: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of chest physicians evidence-based clinical practice guidelines, Chest
Erlich, Talmor, Cartin-Ceba, Gajic, Kor, Prehospitalization antiplatelet therapy is associated with a reduced incidence of acute lung injury: a population-based cohort study, Chest
Gaziano, Brotons, Coppolecchia, Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebocontrolled trial, Lancet
Guan, Ni, Hu, China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China, N Engl J Med
Guirguis-Blake, Evans, Senger, Connor, Whitlock, Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the US preventive services task force, Ann Intern Med
Harris, Taylor, Thielke, Payne, Gonzalez et al., Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform
Ikonomidis, Andreotti, Economou, Stefanadis, Toutouzas et al., Increased proinflammatory cytokines in patients with chronic stable angina and their reduction by aspirin, Circulation
Klok, Kruip, Van Der Meer, Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis, Thromb Res
Kor, Carter, Park, US Critical Illness and Injury Trials Group: Lung Injury Prevention with Aspirin Study Group (USCIITG: LIPS-A). Effect of aspirin on development of ARDS in at-risk patients presenting to the emergency department: the LIPS-A randomized clinical trial, JAMA
Kor, Erlich, Gong, Illness and Injury Trials Group: Lung Injury Prevention Study Investigators. Association of prehospitalization aspirin therapy and acute lung injury: results of a multicenter international observational study of at-risk patients, Crit Care Med
Mcneil, Wolfe, Woods, Effect of aspirin on cardiovascular events and bleeding in the healthy elderly, N Engl J Med
Mehta, Mcauley, Brown, Sanchez, Tattersall et al., HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression, Lancet
Middeldorp, Coppens, Van Haaps, Incidence of venous thromboembolism in hospitalized patients with COVID-19, J Thromb Haemost
Panka, De Grooth, Spoelstra-De Man, Looney, Tuinman, Prevention or treatment of ARDS with aspirin: a review of preclinical models and meta-analysis of clinical studies, Shock
Paranjpe, Fuster, Lala, Association of treatment dose anticoagulation with in-hospital survival among hospitalized patients with COVID-19, J Am Coll Cardiol
Poissy, Goutay, Caplan, COVID-19 Group. Pulmonary embolism in patients with COVID-19: awareness of an increased prevalence, Circulation
Ranucci, Ballotta, Dedda, The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome, J Thromb Haemost
Rapkiewicz, Mai, Carsons, Megakaryocytes and platelet-fibrin thrombi characterize multi-organ thrombosis at autopsy in COVID-19: a case series, EClinicalMedicine
Spiezia, Boscolo, Poletto, COVID-19-related severe hypercoagulability in patients admitted to intensive care unit for acute respiratory failure, Thromb Haemost
Trzeciak, Dellinger, Parrillo, Microcirculatory Alterations in Resuscitation and Shock Investigators. Early microcirculatory perfusion derangements in patients with severe sepsis and septic shock: relationship to hemodynamics, oxygen transport, and survival, Ann Emerg Med
Vanderweele, Ding, Sensitivity analysis in observational research: introducing the E-value, Ann Intern Med
Vanderweele, Principles of confounder selection, Eur J Epidemiol
Vanderweele, Shpitser, On the definition of a confounder, Ann Stat
Varga, Flammer, Steiger, Endothelial cell infection and endotheliitis in COVID-19, Lancet
Vetter, Schober, Regression: the apple does not fall far from the tree, Anesth Analg
Warner, Nylander, Whatling, Anti-platelet therapy: cyclo-oxygenase inhibition and the use of aspirin with particular regard to dual anti-platelet therapy, Br J Clin Pharmacol
Wright, Vogler, Moore, Fibrinolysis shutdown correlation with thromboembolic events in severe COVID-19 infection, J Am Coll Surg
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention, JAMA
Zheng, Roddick, Association of aspirin use for primary prevention with cardiovascular events and bleeding events: a systematic review and meta-analysis, JAMA
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet
Late treatment
is less effective
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