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Does aspirin have an effect on risk of death in patients with COVID-19? A meta-analysis

Ma et al., European Journal of Clinical Pharmacology, doi:10.1007/s00228-022-03356-5, PROSPERO CRD42021241027
Jun 2022  
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Mortality 20% Improvement Relative Risk Aspirin for COVID-19  Ma et al.  META ANALYSIS c19early.org Favorsaspirin Favorscontrol 0 0.5 1 1.5 2+
Meta-analysis of 18 studies with 49,041 COVID-19 patients showing significantly lower mortality with aspirin treatment.
4 meta analyses show significant improvements with aspirin for mortality1-3, mechanical ventilation1, and progression4.
Currently there are 76 aspirin for COVID-19 studies, showing 10% lower mortality [4‑16%], 5% lower ventilation [-5‑15%], 3% lower ICU admission [-11‑16%], 1% higher hospitalization [-4‑6%], and 5% fewer cases [-5‑14%].
risk of death, 20.0% lower, RR 0.80, p = 0.005.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ma et al., 22 Jun 2022, China, peer-reviewed, 13 authors, trial PROSPERO CRD42021241027. Contact: yhsun_ahmu_edu@yeah.net.
This PaperAspirinAll
Does aspirin have an effect on risk of death in patients with COVID-19? A meta-analysis
Shaodi Ma, Wanying Su, Chenyu Sun, Scott Lowe, Zhen Zhou, Haixia Liu, Guangbo Qu, Weihang Xia, Peng Xie, Birong Wu, Juan Gao, Linya Feng, Yehuan Sun
European Journal of Clinical Pharmacology, doi:10.1007/s00228-022-03356-5
Purpose The coronavirus disease 2019 (COVID-19) pandemic has shown unprecedented impact world-wide since the eruption in late 2019. Importantly, emerging reports suggest an increased risk of thromboembolism development in patients with COVID-19. Meanwhile, it is found that aspirin reduced mortality in critically ill patients with non-COVID-19 acute respiratory distress syndrome. Therefore, a meta-analysis was performed to investigate the effects of aspirin on COVID-19 mortality. Methods A systematic literature search was conducted in 10 electronic databases and 4 registries. Random effects models were used to calculate pooled relative risks (RRs) with 95% confidence intervals (Cis) to estimate the effect of aspirin on COVID-19 mortality. Relevant subgroup analyses and sensitivity analyses were also performed. Results The results showed that aspirin use was associated with a reduction in COVID-19 mortality (adjusted RR 0.69; 95% CI 0.50-0.95; P < 0.001). Subgroup analysis found that the low-dose group was associated with a reduced COVID-19 mortality (adjusted RR 0.64; 95% CI 0.48-0.85; P < 0.01). Aspirin use was associated with reduced COVID-19 mortality in Europe and America (crude RR 0.71; 95% CI 0.52-0.98; P = 0.04), and results from cohort studies suggested that aspirin use was a protective factor for COVID-19 mortality (adjusted RR 0.73; 95% CI 0.52-0.99; P = 0.04). Meanwhile, aspirin use was not associated with bleeding risk (crude RR 1.22; 95% CI 0.80-1.87; P = 0.96). Conclusions This meta-analysis found that aspirin use was associated with a reduction in mortality in patients with COVID-19 and not with an increased risk of bleeding.
Supplementary information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s00228-022-03356-5. Author contribution Declarations Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. We did not use individual data but published data. These data have been widely utilized in research and are generally available. Therefore, we confirm that any aspect of the work covered in this manuscript has been conducted with ethical approval. And this study has been registered (registration number: CRD42021241027) with the PROSPERO (International Prospective Register of Systematic Reviews) and was conducted according to the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) statement. Consent for publication All individuals gave written informed consent for publication. The authors are responsible for the reported research, and have participated in the concept and design, analysis and interpretation of data, drafting or revising of the manuscript, and have approved the manuscript as submitted. Conflict of interest The authors declare no competing interests. Research involving human participants and/or animals This article does not contain any studies with human participants or animals performed by any of the authors. We did not use individual data but published data. These data have been widely utilized in research and..
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' 'https://doi.org/10.1016/j.ijid.2021.05.016', 'journal-title': 'Int J Infect Dis'}], 'container-title': 'European Journal of Clinical Pharmacology', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s00228-022-03356-5.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s00228-022-03356-5/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s00228-022-03356-5.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 8, 10]], 'date-time': '2022-08-10T07:07:29Z', 'timestamp': 1660115249000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s00228-022-03356-5'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 6, 22]]}, 'references-count': 64, 'journal-issue': {'issue': '9', 'published-print': {'date-parts': [[2022, 9]]}}, 'alternative-id': ['3356'], 'URL': 'http://dx.doi.org/10.1007/s00228-022-03356-5', 'relation': {}, 'ISSN': ['0031-6970', '1432-1041'], 'subject': [], 'container-title-short': 'Eur J Clin Pharmacol', 'published': {'date-parts': [[2022, 6, 22]]}, 'assertion': [ { 'value': '14 March 2022', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '14 June 2022', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '22 June 2022', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'This article does not contain any studies with human participants or animals ' 'performed by any of the authors. We did not use individual data but published ' 'data. These data have been widely utilized in research and are generally ' 'available. Therefore, we confirm that any aspect of the work covered in this ' 'manuscript has been conducted with ethical approval. And this study has been ' 'registered (registration number: CRD42021241027) with the PROSPERO ' '(International Prospective Register of Systematic Reviews) and was conducted ' 'according to the Preferred Reporting Items for Systemic Reviews and ' 'Meta-Analysis (PRISMA) statement.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'All individuals gave written informed consent for publication. The authors are ' 'responsible for the reported research, and have participated in the concept and ' 'design, analysis and interpretation of data, drafting or revising of the ' 'manuscript, and have approved the manuscript as submitted.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare no competing interests.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Conflict of interest'}}, { 'value': 'This article does not contain any studies with human participants or animals ' 'performed by any of the authors. We did not use individual data but published ' 'data. These data have been widely utilized in research and are generally ' 'available.', 'order': 5, 'name': 'Ethics', 'group': { 'name': 'EthicsHeading', 'label': 'Research involving human participants and/or animals'}}, { 'value': 'This content has been made available to all.', 'name': 'free', 'label': 'Free to read'}]}
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