Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center international prospective registry (HOPE-COVID19)
Santoro et al.
, Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center international..
, European Heart Journal, doi:10.1093/eurheartj/ehab724.3002
Retrospective database analysis of 7,824 patients in the HOPE-COVID19 registry, 730 receiving antiplatelet therapy including aspirin, showing lower mortality with treatment. Authors do not provide results restricted to aspirin.
risk of death, 71.0% lower, RR 0.29, p < 0.001, treatment 730, control 7,094, antiplatelet therapy, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Santoro et al., 14 Oct 2021, retrospective, multiple countries, peer-reviewed, 6 authors.
Pharmacology and Pharmacotherapy – Cardiovascular Pharmacotherapy, Antiplatelet Drugs
Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center international
prospective registry (HOPE-COVID19)
F. Santoro 1 , E. Vitale 1 , I. Nunez Gil 2 , F. Guerra 3 , I. El-Battrawy 4 , N.D. Brunetti 1
University of Foggia, Department of Cardiology, Foggia, Italy; 2 Hospital Clinico San Carlos, Deparment of Cardiology, Madrid, Spain; 3 University
Hospital Riuniti of Ancona, Deparment of Cardiology, Ancona, Italy; 4 University Medical Centre of Mannheim, Deparment of Cardiology, Mannheim,
Funding Acknowledgement: Type of funding sources: None.
Patients treated with APT showed no differences in terms of in-hospital
mortality (18% vs 19%, p=0.64, Log Rank p=0.23), need of invasive ventilation (8.7% vs 8.5%, p=0.88) and bleeding (2.1% vs 2.4%, p=0.43); However, after excluding patients treated only with anticoagulation, APT was
associated with lower mortality rates (Log Rank p<0.01, relative risk 0.79,
95% CI 0.70–0.94) (Figure 1).
At multivariable analysis including age, gender, diabetes, hypertension,
respiratory failure, pre-hospital therapy with antiplatelet drugs, in-hospital
APT, and anticoagulation therapy, in-hospital APT was associated with a
lower mortality risk (relative risk 0.29, 95% CI 0.22–0.38, p<0.001).
Conclusions: APT during hospitalization for COVID-19 could be associated with lower mortality risk without increased risk of bleeding. Randomized trials are needed to conﬁrm these preliminary data.
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Background: No standard therapy is currently recommended for Coronavirus-19 disease (COVID-19). Autopsy studies showed high prevalence of
platelet-ﬁbrin rich micro-thrombi in several organs. Aim of the study was
to evaluate safety and efﬁcacy of antiplatelet therapy (APT) in COVID-19
hospitalized patients and its impact on survival.
Methods: 7824 consecutive patients with COVID-19 were enrolled in a
multicenter-international prospective registry (HOPE-COVID19). Clinical
data and in-hospital complications were recorded. AP regimen, including
aspirin and other antiplatelet drugs, was obtained for each patient.
Results: During hospitalization 730 (9.3%) patients received AP drugs with
single (93%, n=680) or dual APT (7%, n=50). Patients treated with APT
were older (73±12 vs 62±17 years, p<0.01), more frequently male (70%
vs 64%, p<0.01) and had higher prevalence of diabetes (39.5% vs 17%,
is less effective
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