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0 0.5 1 1.5 2+ Mortality, day 28 57% Improvement Relative Risk Mortality, day 14 15% Ventilation 20% ICU admission 29% Progression 33% Progression, resp. failure 76% Progression, AKI 44% Progression, DIC 86% Progression, liver dysfunct.. 25% c19early.org/e Singla et al. NCT04410328 Aspirin RCT LATE TREATMENT Is late treatment with aspirin+dipyridamole beneficial for COVID-19? RCT 98 patients in the USA (October 2020 - April 2021) Lower mortality with aspirin+dipyridamole (not stat. sig., p=0.44) Singla et al., PLOS ONE, doi:10.1371/journal.pone.0274243 Favors aspirin Favors control
A randomized controlled trial to evaluate outcomes with Aggrenox in patients with SARS-CoV-2 infection
Singla et al., A randomized controlled trial to evaluate outcomes with Aggrenox in patients with SARS-CoV-2 infection, PLOS ONE, doi:10.1371/journal.pone.0274243, NCT04410328
Jan 2023   Source   PDF  
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RCT 98 hospitalized patients in the USA, 49 treated with aspirin and dipyridamole, showing improved results with treatment, but without statistical significance.
risk of death, 57.4% lower, RR 0.43, p = 0.44, treatment 3 of 49 (6.1%), control 5 of 49 (10.2%), adjusted per study, odds ratio converted to relative risk, multivariable, day 28.
risk of death, 15.0% lower, OR 0.85, p = 0.87, treatment 49, control 49, adjusted per study, multivariable, day 14, RR approximated with OR.
risk of mechanical ventilation, 20.0% lower, RR 0.80, p = 1.00, treatment 4 of 49 (8.2%), control 5 of 49 (10.2%), NNT 49.
risk of ICU admission, 28.6% lower, RR 0.71, p = 0.76, treatment 5 of 49 (10.2%), control 7 of 49 (14.3%), NNT 25.
risk of progression, 33.3% lower, RR 0.67, p = 0.74, treatment 4 of 49 (8.2%), control 6 of 49 (12.2%), NNT 24, day 28.
risk of progression, 76.3% lower, RR 0.24, p = 0.22, treatment 4 of 49 (8.2%), control 7 of 49 (14.3%), odds ratio converted to relative risk, respiratory failure, day 28.
risk of progression, 44.4% lower, RR 0.56, p = 0.39, treatment 5 of 49 (10.2%), control 9 of 49 (18.4%), NNT 12, AKI.
risk of progression, 85.7% lower, RR 0.14, p = 0.24, treatment 0 of 49 (0.0%), control 3 of 49 (6.1%), NNT 16, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), DIC.
risk of progression, 25.0% lower, RR 0.75, p = 0.62, treatment 9 of 49 (18.4%), control 12 of 49 (24.5%), NNT 16, liver dysfunction.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Singla et al., 30 Jan 2023, Randomized Controlled Trial, USA, peer-reviewed, 26 authors, study period 1 October, 2020 - 30 April, 2021, this trial uses multiple treatments in the treatment arm (combined with dipyridamole) - results of individual treatments may vary, trial NCT04410328 (history).
Contact: as3321@njms.rutgers.edu.
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Abstract: PLOS ONE RESEARCH ARTICLE A randomized controlled trial to evaluate outcomes with Aggrenox in patients with SARS-CoV-2 infection a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Singla A, Dadario NB, Singla A, Greenberg P, Yan R, Nanda A, et al. (2023) A randomized controlled trial to evaluate outcomes with Aggrenox in patients with SARS-CoV-2 infection. PLoS ONE 18(1): e0274243. https://doi.org/10.1371/journal. pone.0274243 Amit Singla ID1*, Nicholas B. Dadario2, Ashima Singla3, Patricia Greenberg4, Rachel Yan2, Anil Nanda1,2, Detlev Boison2,5, Rakesh Malhotra6, Sunil Patel7, Suri Nipun7, Kaur Maninderpal7, Dorothy Castro7, Sanaa Bdiiwi7, Hala Boktor7, Htay Htay Kyi7, Anne Sutherland7, Amee Patrawalla7, Kevin Ly1, Yingda Xie7, Ashish Sonig1, Priyank Khandelwal1, James Liu1, Joseph Koziol8, Diana Finkle7, Sara Subanna ID1, Steven K. Libutti9 1 Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States of America, 2 Department of Neurological Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America, 3 Department of OBGYN, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America, 4 Biostatistics and Epidemiology Services Center (RUBIES), Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America, 5 Brain Health Institute, Rutgers University, Piscataway, New Jersey, United States of America, 6 Department of Medicine, Division of Nephrology, UCSD, San Diego, California, United States of America, 7 Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, United States of America, 8 Department of Neurological Surgery, Saint Barnabas Medical Center, Livingston, New Jersey, United States of America, 9 Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America * As3321@njms.rutgers.edu Abstract Editor: George Vousden, Public Library of Science, UNITED KINGDOM Received: January 20, 2022 Background Accepted: August 23, 2022 Coronavirus disease 2019 (COVID-19) is an immunoinflammatory and hypercoagulable state that contributes to respiratory distress, multi-organ dysfunction, and mortality. Dipyridamole, by increasing extracellular adenosine, has been postulated to be protective for COVID-19 patients through its immunosuppressive, anti-inflammatory, anti-coagulant, vasodilatory, and anti-viral actions. Likewise, low-dose aspirin has also demonstrated protective effects for COVID-19 patients. This study evaluated the effect of these two drugs formulated together as Aggrenox in hospitalized COVID-19 patients. Published: January 30, 2023 Copyright: © 2023 Singla et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting information files. Methods Funding: This was an independent, investigatorinitiated study supported by Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI). BIPI had no role in the design, analysis or interpretation of the results in this study; BIPI was given the opportunity to review the manuscript for medical and scientific accuracy as it relates to BIPI substances, as well..
Late treatment
is less effective
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