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Association of Pre-Hospital Antiplatelet Therapy with Survival in Patients Hospitalized with COVID-19: A Propensity Score-Matched Analysis

Chow et al., Journal of Thrombosis and Haemostasis, doi:10.1111/jth.15517
Aug 2021  
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Mortality 19% Improvement Relative Risk Ventilation 3% Aspirin for COVID-19  Chow et al.  Prophylaxis Is prophylaxis with aspirin beneficial for COVID-19? PSM retrospective 17,347 patients in the USA Lower mortality with aspirin (p=0.005) c19early.org Chow et al., J. Thrombosis and Haemost.., Aug 2021 Favorsaspirin Favorscontrol 0 0.5 1 1.5 2+
PSM retrospective 6,781 hospitalized patients ≥50 years old in the USA who were on pre-hospital antiplatelet therapy (84% aspirin), and 10,566 matched controls, showing lower mortality with treatment.
Standard of Care (SOC): SOC for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved. Low-cost treatments were excluded, reducing the probability of treatment—especially early—due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments. This may explain in part the very high mortality seen in this study. Results may differ in countries with improved SOC.
risk of death, 19.0% lower, HR 0.81, p < 0.005, treatment 1,280 of 6,781 (18.9%), control 2,271 of 10,566 (21.5%), NNT 38, adjusted per study, Kaplan Meier.
risk of mechanical ventilation, 2.8% lower, HR 0.97, p = 0.21, treatment 2,122 of 6,781 (31.3%), control 3,403 of 10,566 (32.2%), NNT 109.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chow et al., 29 Aug 2021, retrospective, propensity score matching, USA, peer-reviewed, 12 authors.
This PaperAspirinAll
Association of prehospital antiplatelet therapy with survival in patients hospitalized with COVID‐19: A propensity score‐matched analysis
MD Jonathan H Chow, PhD Ying Ying Yin, MD David P Yamane, MD Danielle Davison, MD Ryan J Keneally, MD Katrina Katrina Hawkins, K Gage Parr, Mustafa Al‐mashat, MD, MBA Jeffery S Berger, PharmD, PA-C Reamer L Bushardt, MD, MPH Michael A Mazzeffi, MD Stuart J Nelson
Journal of Thrombosis and Haemostasis, doi:10.1111/jth.15517
This report describes a cohort observational clinical study. The authors state that the report includes every item in the STROBE checklist for cohort studies.
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"short-title": [], "source": "Crossref", "subject": [ "Hematology" ], "subtitle": [], "title": "Association of prehospital antiplatelet therapy with survival in patients hospitalized with COVID‐19: A propensity score‐matched analysis", "type": "journal-article", "update-policy": "http://dx.doi.org/10.1016/elsevier_cm_policy", "volume": "19" }
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