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0 0.5 1 1.5 2+ Mortality 0% Improvement Relative Risk Remdesivir  Sokolski et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 548 patients in Poland No significant difference in mortality Sokolski et al., Scientific Reports, Feb 2024 Favors remdesivir Favors control

Antiplatelet therapy prior to COVID-19 infection impacts on patients mortality: a propensity score-matched cohort study

Sokolski et al., Scientific Reports, doi:10.1038/s41598-024-55407-9
Feb 2024  
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Retrospective 2,170 hospitalized COVID-19 patients showing no difference in mortality with remdesivir in unadjusted results.
Gérard, Wu, Zhou show significantly increased risk of acute kidney injury with remdesivir.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
Study covers remdesivir and aspirin.
risk of death, no change, HR 1.00, p = 1.00, treatment 88, control 460, Cox proportional hazards, day 90.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sokolski et al., 28 Feb 2024, retrospective, Poland, peer-reviewed, 11 authors. Contact:
This PaperRemdesivirAll
Antiplatelet therapy prior to COVID-19 infection impacts on patients mortality: a propensity score-matched cohort study
Mateusz Sokolski, Konrad Reszka, Barbara Adamik, Katarzyna Kilis-Pstrusinska, Weronika Lis, Michał Pomorski, Janusz Sokolowski, Adrian Doroszko, Katarzyna Madziarska, Ewa Anita Jankowska, Marcin Protasiewicz
Scientific Reports, doi:10.1038/s41598-024-55407-9
One of the major pathomechanisms of COVID-19 is the interplay of hyperinflammation and disruptions in coagulation processes, involving thrombocytes. Antiplatelet therapy (AP) by antiinflammatory effect and inhibition of platelet aggregation may affect these pathways. The aim of this study was to investigate if AP has an impact on the in-hospital course and medium-term outcomes in hospitalized COVID-19 patients. The study population (2170 COVID-19 patients: mean ± SD age 60 ± 19 years old, 50% male) was divided into a group of 274 patients receiving any AP prior to COVID-19 infection (AP group), and after propensity score matching, a group of 274 patients without previous AP (non-AP group). Patients from the AP group were less frequently hospitalized in the intensive care unit: 9% vs. 15%, 0.55 (0.33-0.94), developed less often shock: 9% vs. 15%, 0.56 (0.33-0.96), and required less aggressive forms of therapy. The AP group had more coronary revascularizations: 5% vs. 1%, 3.48 (2.19-5.55) and strokes/TIA: 5% vs. 1%, 3.63 (1.18-11.2). The bleeding rate was comparable: 7% vs. 7%, 1.06 (0.54-2.06). The patients from the AP group had lower 3-month mortality: 31% vs. 39%, 0.69 (0.51-0.93) and didn't differ significantly in 6-month mortality: 34% vs. 41%, 0.79 (0.60-1.04). When analyzing the subgroup with a history of myocardial infarction and/or coronary revascularization and/or previous stroke/transient ischemic attack and/or peripheral artery disease, AP had a beneficial effect on both 3-month: 37% vs. 56%, 0.58 (0.40-0.86) and 6-month mortality: 42% vs. 57%, 0.63 (0.44-0.92). Moreover, the favourable effect was highly noticeable in this subgroup where acetylsalicylic acid was continued during hospitalization with reduction of in-hospital: 19% vs. 43%, 0.31 (0.15-0.67), 3-month: 30% vs. 54%, 044 (0.26-0.75) and 6-month mortality: 33% vs. 54%, 0.49 (0.29-0.82) when confronted with the subgroup who had acetylsalicylic acid suspension during hospitalization. The AP may have a beneficial impact on hospital course and mortality in COVID-19 and shouldn't be discontinued, especially in high-risk patients. Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health crisis 1 . SARS-CoV-2 is a single-stranded RNA virus with a high mutation rate 2,3 . Five SARS-CoV-2 variants (alpha, beta, gamma, delta, and omicron) have been identified by WHO as variants of concern. While approximately 80% of SARS-CoV-2 infections are mild to moderate, the clinical presentation and case fatality rate vary depending on the viral variant and comorbidities 4,5 . Thus, the infection fatality rates vary from 0.3 to 5%. The major causes of death are respiratory failure, sepsis/multi-organ failure, OPEN
Author contributions Conceptualization: M.S., M.P.r; formal analysis: M.S., M.Pr..; investigation: M.S., K.R., B.A., K.K-P, W.L., M.Po., J.S., A.D., K.M., E.A.J., M.Pr.; methodology: M.S., M.Pr.; project administration: A.D., K.M., M.Pr., E.A.J.; supervision: M.S., A.D., K.M., M.Pr., EAJ.; visualization: M.S., K.R; writing-original draft, M.S., K.R.; writingreview and editing, M.S., K.R., K.R., B.A., K. K-P, W.L., M.Po., J.S., A.D., K.M., M.Pr., E.A.J. All authors have contributed substantially to this work and have read and agreed to the published version of the manuscript. Competing interests The authors declare no competing interests.
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Late treatment
is less effective
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