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0 0.5 1 1.5 2+ Mortality -13% Improvement Relative Risk Death/intubation -2% Pan et al. Aspirin for COVID-19 Prophylaxis Is prophylaxis with aspirin beneficial for COVID-19? Retrospective 762 patients in the USA (March - April 2020) No significant difference in outcomes seen Pan et al., Heart & Lung, doi:10.1016/j.hrtlng.2021.04.010 Favors aspirin Favors control
Pre-hospital antiplatelet medication use on COVID-19 disease severity
Pan et al., Heart & Lung, doi:10.1016/j.hrtlng.2021.04.010
Pan et al., Pre-hospital antiplatelet medication use on COVID-19 disease severity, Heart & Lung, doi:10.1016/j.hrtlng.2021.04.010
May 2021   Source   PDF  
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Retrospective 762 COVID+ hospitalized patients in the USA, 239 on antiplatelet medication (199 aspirin), showing no significant differences in outcomes.
For more discussion see [].
risk of death, 13.0% higher, OR 1.13, p = 0.63, treatment 239, control 523, adjusted per study, MOS 6 vs. <6, multivariable, RR approximated with OR.
risk of death/intubation, 2.0% higher, OR 1.02, p = 0.93, treatment 239, control 523, adjusted per study, MOS 5+ vs. <5, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pan et al., 26 May 2021, retrospective, USA, peer-reviewed, 11 authors, study period 1 March, 2020 - 9 April, 2020.
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Pre-hospital antiplatelet medication use on COVID-19 disease severity
MD Darren Pan, MD Ada Ip, MS Serena Zhan, MD, MPH Isaac Wasserman, BS e , Daniel J Snyder, BA Alexandra Z Agathis, BA e , Jeong Nikhil Shamapant, Jeong Yun Yang, BS Akila Pai, PhD Madhu Mazumdar, MD Hooman Poor
Heart & Lung, doi:10.1016/j.hrtlng.2021.04.010
Measurements: We captured baseline demographic, pre-hospitalization antiplatelet medication use, and clinical encounter data for all patients who met inclusion criteria. The primary endpoint was peak score on a 6point modified ordinal scale (MOS), which is based on World Health Organization blueprint R&S groups, used to grade severity of illness through clinical outcomes of interest. Scores indicate the following: 1 À COVID-19 infection not requiring hospitalization, 2 À requiring hospitalization but not supplemental oxygen, 3 À hospitalization requiring supplemental oxygen, 4 À hospitalization requiring high-flow nasal cannula (HFNC) or non-invasive positive pressure ventilation (NIPPV), 5 À hospitalization requiring intubation or extracorporeal membrane oxygenation (ECMO), 6 À death. Multivariable adjusted partial proportional odds model (PPOM) was performed to examine the association between pre-hospitalization antiplatelet medication use and likelihood of each MOS score. Main Results: Of 762 people admitted with COVID-19, 239 (31.4%) used antiplatelet medications pre-hospitalization while 523 (68.6%) did not. Antiplatelet users were older and had more co-morbidities at baseline. Before adjusting for covariates, patients who used antiplatelet medications pre-hospitalization were more likely than non-users to have peak MOS score 6 (death, OR 1.75, 95% CI 1.21À2.52), peak MOS score 5 (intubation/ECMO or death, OR 1.4, 95% CI 1.00À1.98) and peak MOS score 4 (HFNC, NIPPV, intubation/ECMO or death, OR 1.40, 95% CI 1.01À1.94). On multivariable adjusted PPOM analysis controlling for 13 covariates, there were no longer any significant differences in peak MOS scores between users and non-users. Conclusions: After adjusting for covariates, pre-hospital antiplatelet use was not associated with COVID-19 severity in hospitalized patients.
Author Contributions Darren Pan and Ada Ip performed chart review and wrote the manuscript. Serena Zhan performed statistical analysis and contributed to writing and editing. Isaac Wasserman, Daniel J. Snyder, Alexandra Z. Agathis, Nikhil Shamapant, Jeong Yun Yang, and Akila Pai performed chart review and contributed to editing. Madhu Mazumdar contributed to editing and provided critical feedback which helped to shape the manuscript. Hooman Poor edited, provided guidance regarding overall direction, and contributed to writing the manuscript.
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