Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center international prospective registry (HOPE-COVID19)

DOI record: { "DOI": "10.1093/eurheartj/ehab724.3002", "ISSN": [ "0195-668X", "1522-9645" ], "URL": "http://dx.doi.org/10.1093/eurheartj/ehab724.3002", "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&amp;lt;0.01), more frequently male (70% vs 64%, p&amp;lt;0.01) and had higher prevalence of diabetes (39.5% vs 17%, p&amp;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&amp;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&amp;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>", "author": [ { "affiliation": [ { "name": "University of Foggia, Department of Cardiology, Foggia, Italy" } ], "family": "Santoro", "given": "F", "sequence": "first" }, { "affiliation": [ { "name": "University of Foggia, Department of Cardiology, Foggia, Italy" } ], "family": "Vitale", "given": "E", "sequence": "additional" }, { "affiliation": [ { "name": "Hospital Clinico San Carlos, Deparment of Cardiology, Madrid, Spain" } ], "family": "Nunez Gil", "given": "I", "sequence": "additional" }, { "affiliation": [ { "name": "University Hospital Riuniti of Ancona, Deparment of Cardiology, Ancona, Italy" } ], "family": "Guerra", "given": "F", "sequence": "additional" }, { "affiliation": [ { "name": "University Medical Centre of Mannheim, Deparment of Cardiology, Mannheim, Germany" } ], "family": "El-Battrawy", "given": "I", "sequence": "additional" }, { "affiliation": [ { "name": "University of Foggia, Department of Cardiology, Foggia, Italy" } ], "family": "Brunetti", "given": "N D", "sequence": "additional" } ], "container-title": "European Heart Journal", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2021, 10, 20 ] ], "date-time": "2021-10-20T19:41:36Z", "timestamp": 1634758896000 }, "deposited": { "date-parts": [ [ 2022, 1, 4 ] ], "date-time": "2022-01-04T05:59:07Z", "timestamp": 1641275947000 }, "indexed": { "date-parts": [ [ 2022, 4, 1 ] ], "date-time": "2022-04-01T09:23:37Z", "timestamp": 1648805017036 }, "is-referenced-by-count": 0, "issue": "Supplement_1", "issued": { "date-parts": [ [ 2021, 10, 1 ] ] }, "journal-issue": { "issue": "Supplement_1", "published-online": { "date-parts": [ [ 2021, 10, 14 ] ] }, "published-print": { "date-parts": [ [ 2021, 10, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 10, 1 ] ], "date-time": "2021-10-01T00:00:00Z", "timestamp": 1633046400000 } } ], "link": [ { "URL": "https://academic.oup.com/eurheartj/article-pdf/42/Supplement_1/ehab724.3002/41050914/ehab724.3002.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "syndication" }, { "URL": "https://academic.oup.com/eurheartj/article-pdf/42/Supplement_1/ehab724.3002/41050914/ehab724.3002.pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "286", "original-title": [], "prefix": "10.1093", "published": { "date-parts": [ [ 2021, 10, 1 ] ] }, "published-online": { "date-parts": [ [ 2021, 10, 14 ] ] }, "published-other": { "date-parts": [ [ 2021, 10, 1 ] ] }, "published-print": { "date-parts": [ [ 2021, 10, 12 ] ] }, "publisher": "Oxford University Press (OUP)", "reference-count": 0, "references-count": 0, "relation": {}, "resource": { "primary": { "URL": "https://academic.oup.com/eurheartj/article/doi/10.1093/eurheartj/ehab724.3002/6394238" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center international prospective registry (HOPE-COVID19)", "type": "journal-article", "volume": "42" }