Impact of prior use of antiplatelets on COVID-19 susceptibility, progression, and severity: a population-based study
Ángela Prieto-Campo, Maruxa Zapata-Cachafeiro, Manuel Portela-Romero, María Piñeiro-Lamas, Adolfo Figueiras, Ángel Salgado-Barreira
Revista Española de Cardiología (English Edition), doi:10.1016/j.rec.2023.12.004
Introduction and objectives: Hypercoagulability and thromboembolism are processes that arise from severe acute respiratory syndrome coronavirus 2 infection and are responsible for a high degree of coronavirus disease 2019 (COVID-19)-related morbidity and mortality. This study sought to assess the effect of antiplatelet drugs on COVID-19 severity (risk of hospitalization and mortality), susceptibility to severe acute respiratory syndrome coronavirus 2 infection, and progression to severe COVID-19.
Methods: We conducted a population-based case-control study in a northwestern region of Spain in 2020. The study involved 3060 participants with a positive polymerase chain reaction test who were hospitalized, 26 757 participants with a positive polymerase chain reaction test who were not hospitalized, and 56 785 healthy controls.
Results: Triflusal seemed to be associated with a significant increase in risk of hospitalization (aOR, 1.97; 95%CI, 1.27-3.04) and susceptibility to infection (OR, 1.45; 95%CI, 1.07-1.96). It also appeared to lead to a nonsignificant increase in the risk of mortality (OR, 2.23; 95%CI, 0.89-5.55) and/or progression to more severe disease stages (OR, 1.42; 95%CI, 0.8-2.51). Aspirin seemed to be associated with a statistically significant decrease in susceptibility to severe acute respiratory syndrome coronavirus 2 infection (OR, 0.92; 95%CI, 0.86-0.98). Conclusions: Triflusal use appears to increase the risk of susceptibility to COVID-19 infection and an even higher risk of hospitalization, whereas the other antiplatelets could be associated with a reduction in the risk of the various outcomes or have no effect on risk. These findings could support reconsideration of triflusal prescription in COVID-19 pandemic situations.
Medical Devices (AEMPS), and conducted in accordance with the principles of the Declaration of Helsinki and current legislation on biomedical research. The study protocol is registered in the EU Electronic Register of Post-Authorisation Studies and is available online at https://www.encepp.eu/encepp/viewResource.htm?id=44588. Automated data extraction was performed and anonymized to ensure that the participants could not be identified and therefore it was not necessary to obtain informed consent from the participants.
STATEMENT ON THE USE OF ARTIFICIAL INTELLIGENCE No artificial intelligence was used in the preparation of this article.
AUTHORS' CONTRIBUTIONS A. Prieto-Campo designed study and wrote the paper. M. Zapata-Cachafeiro designed the study and wrote the paper. M. Portela-Romero designed study and revised the paper. M. Piñeiro-Lamas designed study, analyzed data and revised the paper. A. Figueiras designed the study, analyzed data, and revised the paper. A. Salgado-Barreira designed the study, analyzed data and revised the paper. All authors read and approved the final version.
CONFLICTS OF INTEREST None.
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