Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center international prospective registry (HOPE-COVID19)
F Santoro, E Vitale, I Nunez Gil, F Guerra, I El-Battrawy, N D Brunetti
Background: No standard therapy is currently recommended for . 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%, p<0.01).
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'abstract': '<jats:title>Abstract</jats:title>\n'
' <jats:sec>\n'
' <jats:title>Background</jats:title>\n'
' <jats:p>No standard therapy is currently recommended for Corona-virus-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.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>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.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>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&lt;0.01), more frequently male (70% vs 64%, p&lt;0.01) and had higher '
'prevalence of diabetes (39.5% vs 17%, p&lt;0.01).</jats:p>\n'
' <jats:p>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&lt;0.01, relative risk 0.79, 95% CI 0.70–0.94) (Figure 1).</jats:p>\n'
' <jats:p>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&lt;0.001).</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Conclusions</jats:title>\n'
' <jats:p>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.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Funding Acknowledgement</jats:title>\n'
' <jats:p>Type of funding sources: None. Figure 1</jats:p>\n'
' </jats:sec>',
'DOI': '10.1093/eurheartj/ehab724.3002',
'type': 'journal-article',
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'date-time': '2021-10-20T19:41:36Z',
'timestamp': 1634758896000},
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'title': 'Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center '
'international prospective registry (HOPE-COVID19)',
'prefix': '10.1093',
'volume': '42',
'author': [ { 'given': 'F',
'family': 'Santoro',
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'affiliation': [{'name': 'University of Foggia, Department of Cardiology, Foggia, Italy'}]},
{ 'given': 'E',
'family': 'Vitale',
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'affiliation': [{'name': 'University of Foggia, Department of Cardiology, Foggia, Italy'}]},
{ 'given': 'I',
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'affiliation': [ { 'name': 'Hospital Clinico San Carlos, Deparment of Cardiology, Madrid, '
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{ 'given': 'F',
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'affiliation': [ { 'name': 'University Hospital Riuniti of Ancona, Deparment of Cardiology, '
'Ancona, Italy'}]},
{ 'given': 'I',
'family': 'El-Battrawy',
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'affiliation': [ { 'name': 'University Medical Centre of Mannheim, Deparment of Cardiology, '
'Mannheim, Germany'}]},
{ 'given': 'N D',
'family': 'Brunetti',
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'affiliation': [{'name': 'University of Foggia, Department of Cardiology, Foggia, Italy'}]}],
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