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All Studies   Meta Analysis       

Decreased In-Hospital Mortality Associated with Aspirin Administration in Hospitalized Patients Due to Severe COVID-19

Haji Aghajani et al., Journal of Medical Virology, doi:10.1002/jmv.27053
Apr 2021  
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Mortality 19% Improvement Relative Risk Remdesivir  Haji Aghajani et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 991 patients in Iran Lower mortality with remdesivir (not stat. sig., p=0.49) c19early.org Haji Aghajani et al., J. Medical Virol.., Apr 2021 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 991 hospitalized patients in Iran focusing on aspirin use but also showing results for HCQ, remdesivir, and favipiravir.
Gérard, Zhou, Wu, Kamo, Choi, Kim show significantly increased risk of acute kidney injury with remdesivir.
Remdesivir efficacy disappears with longer followup. Mixed-effects meta-regression of efficacy as a function of followup duration across all remdesivir studies shows decreasing efficacy with longer followup7. This may reflect antiviral efficacy being offset by serious adverse effects of treatment.
Followup duration (days) Efficacy Remdesivir mortality efficacy decreases with longer followup 0 15 30 45 60 75 90 105 -25% 0% 25% 50% c19early.org December 2024 mixed-effects meta-regression slope -0.58 [95% CI -0.92 to -0.24] p=0.00089
Study covers HCQ, aspirin, remdesivir, and favipiravir.
risk of death, 18.6% lower, HR 0.81, p = 0.49, treatment 46, control 945, univariate Cox proportional regression.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Haji Aghajani et al., 29 Apr 2021, retrospective, Iran, peer-reviewed, 7 authors.
This PaperRemdesivirAll
Decreased in‐hospital mortality associated with aspirin administration in hospitalized patients due to severe COVID‐19
Mohammad Haji Aghajani, Omid Moradi, Hossein Amini, Hamed Azhdari Tehrani, Elham Pourheidar, Mohammad M Rabiei, Mohammad Sistanizad
Journal of Medical Virology, doi:10.1002/jmv.27053
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
The main limitations of our study were the retrospective pattern of the study and lack of data about the probable adverse effect of aspirin, such as bleeding components. In conclusion, based on the result of our study, in patients who received aspirin, a relevant underlying condition such as hypertension, diabetes, and coronary artery disease was more prevalent. These patients had a more severe course of the disease and a longer duration of hospitalization. By adjustment of the effect of underlying conditions and confounding factors, aspirin use in severe hospitalized COVID-19 patients is independently associated with a 25% decrease in mortality rate. So, by considering all the probable described mechanisms and the results of other studies in this regard, we recommend using aspirin during the hospital stay for all patients with the diagnosis of severe COVID-19. ACKNOWLEDGMENT This study was supported via the Deputy of research and technology, Shahid Beheshti University of Medical Sciences, Iran. No specific grants from funding agencies, commercial, and non-profit sectors were received. CONFLICT OF INTERESTS The authors declare that there are no conflicts of interest. AUTHOR CONTRIBUTIONS
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Late treatment
is less effective
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