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All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Mortality 22% Improvement Relative Risk Mortality (b) 58% Ventilation 9% Ventilation (b) 50% Progression 30% primary Progression (b) 60% primary Aspirin  RESIST  LATE TREATMENT  RCT Is late treatment with aspirin beneficial for COVID-19? RCT 661 patients in India (July 2020 - January 2021) Lower progression with aspirin (not stat. sig., p=0.46) Ghati et al., BMC Infectious Diseases, Jul 2022 Favors aspirin Favors control

Statin and aspirin as adjuvant therapy in hospitalised patients with SARS-CoV-2 infection: a randomised clinical trial (RESIST trial)

Ghati et al., BMC Infectious Diseases, doi:10.1186/s12879-022-07570-5, RESIST, CTRI/2020/07/026791
Jul 2022  
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RCT hospitalized patients in India, 224 treated with atorvastatin, 225 with aspirin, and 225 with both, showing lower serum interleukin-6 levels with aspirin, but no statistically significant changes in other outcomes. Low dose aspirin 75mg daily for 10 days.
risk of death, 22.1% lower, RR 0.78, p = 0.62, treatment 11 of 442 (2.5%), control 7 of 219 (3.2%), NNT 141, aspirin and aspirin/atorvastatin vs. control, modified intention-to-treat.
risk of death, 57.5% lower, RR 0.42, p = 0.22, treatment 3 of 221 (1.4%), control 7 of 219 (3.2%), NNT 54, aspirin vs. control, modified intention-to-treat.
risk of mechanical ventilation, 9.2% lower, RR 0.91, p = 0.80, treatment 11 of 442 (2.5%), control 6 of 219 (2.7%), NNT 398, aspirin and aspirin/atorvastatin vs. control, modified intention-to-treat.
risk of mechanical ventilation, 50.5% lower, RR 0.50, p = 0.34, treatment 3 of 221 (1.4%), control 6 of 219 (2.7%), NNT 72, aspirin vs. control, modified intention-to-treat.
risk of progression, 30.0% lower, HR 0.70, p = 0.46, treatment 11 of 442 (2.5%), control 7 of 219 (3.2%), NNT 141, aspirin and aspirin/atorvastatin vs. control, Cox proportional hazards, modified intention-to-treat, primary outcome.
risk of progression, 60.0% lower, HR 0.40, p = 0.18, treatment 3 of 221 (1.4%), control 7 of 219 (3.2%), NNT 54, aspirin vs. control, Cox proportional hazards, modified intention-to-treat, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ghati et al., 9 Jul 2022, Randomized Controlled Trial, India, peer-reviewed, 14 authors, study period 28 July, 2020 - 27 January, 2021, average treatment delay 6.0 days, trial CTRI/2020/07/026791 (RESIST).
Contact: (corresponding author).
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Statin and aspirin as adjuvant therapy in hospitalised patients with SARS-CoV-2 infection: a randomised clinical trial (RESIST trial)
Nirmal Ghati, Sushma Bhatnagar, Manjit Mahendran, Abhishek Thakur, Kshitij Prasad, Devesh Kumar, Tanima Dwivedi, Kalaivani Mani, Pawan Tiwari, Ritu Gupta, Anant Mohan, Anita Saxena, Randeep Guleria, Siddharthan Deepti
BMC Infectious Diseases, doi:10.1186/s12879-022-07570-5
Background: Statins and aspirin have been proposed for treatment of COVID-19 because of their anti-inflammatory and anti-thrombotic properties. Several observational studies have shown favourable results. There is a need for a randomised controlled trial. Methods: In this single-center, open-label, randomised controlled trial, 900 RT-PCR positive COVID-19 patients requiring hospitalisation, were randomly assigned to receive either atorvastatin 40 mg (Group A, n = 224), aspirin 75 mg (Group B, n = 225), or both (Group C, n = 225) in addition to standard of care for 10 days or until discharge whichever was earlier or only standard of care (Group D, n = 226). The primary outcome variable was clinical deterioration to WHO Ordinal Scale for Clinical Improvement ≥ 6. The secondary outcome was change in serum C-reactive protein, interleukin-6, and troponin I. Results: The primary outcome occurred in 25 (2.8%) patients: 7 (3.2%) in Group A, 3 (1.4%) in Group B, 8 (3.6%) in Group C, and 7 (3.2%) in Group D. There was no difference in primary outcome across the study groups (P = 0.463). Comparison of all patients who received atorvastatin or aspirin with the control group (Group D) also did not show any benefit [Atorvastatin: HR 1.0 (95% CI 0.41-2.46) P = 0.99; Aspirin: HR 0.7 (95% CI 0.27-1.81) P = 0.46]. The secondary outcomes revealed lower serum interleukin-6 levels among patients in Groups B and C. There was no excess of adverse events. Conclusions: Among patients admitted with mild to moderate COVID-19 infection, additional treatment with aspirin, atorvastatin, or a combination of the two does not prevent clinical deterioration.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s12879-022-07570-5. Additional file 1. eFigure 1. Institute Covid-19 treatment protocol. eFigure 2. Probability of having WHO Ordinal Scale for Clinical Improvement < 6 in the study groups over time (Intension-to-treat analysis). eFigure 3. Probability of having WHO Ordinal Scale for Clinical Improvement < 6 in the study groups over time (Per protocol analysis). eFigure 4. Probability of having WHO Ordinal Scale for Clinical Improvement < 6 in the study groups over time (as treated analysis). eTable 1. Distribution of adverse events in the study groups. Author contributions NG: Conceptualization, Methodology, Data curation, Visualization, Writing-Original draft preparation, Writing-Review and Editing; SuB: Project Administration, Supervision, Resource; MM, AT,KP, DK: Data curation, Methodology, Investigation; PT, TD: Methodology, Investigation; KM: Software, Formal Analysis, Validation; RiG, AM, RG, AS: Supervision, Resources; SD: Project Administration, Supervision, Conceptualization, Methodology, Investigation, Data curation, Visualization, Writing-Original draft preparation, Writing-Review and Editing. NG, SD have verified the underlying data. All authors have read and approved the final manuscript. Funding There was no funding source for this study. Declarations Ethics approval and consent to participate The trial was conducted in accordance..
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Late treatment
is less effective
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