Effect of Aspirin Use on the Adverse Outcomes in Patients Hospitalized for COVID-19
Poornima Vinod, Vinod Krishnappa, William Rathell Jr, Saira Amir, Subrina Sundil, Godwin Dogbey, Hiten Patel, William Herzog
Cardiology Research, doi:10.14740/cr1645
Background: Coronavirus disease 2019 (COVID-19) triggers multiple components of the immune system and causes inflammation of endothelial walls across vascular beds, resulting in respiratory failure, arterial and venous thrombosis, myocardial injury, and multi-organ failure leading to death. Early in the COVID-19 pandemic, aspirin was suggested for the treatment of symptomatic individuals, given its analgesic, antipyretic, anti-inflammatory, anti-thrombotic, and antiviral effects. This study aimed to evaluate the association of aspirin use with various clinical outcomes in patients hospitalized for COVID-19.
Methods: This was a retrospective study involving patients aged ≥ 18 years and hospitalized for COVID-19 from March 2020 to October 2020. Primary outcomes were acute cardiovascular events (ST elevation myocardial infarction (STEMI), type 1 non-ST elevation myocardial infarction (NSTEMI), acute congestive heart failure (CHF), and acute stroke) and death. Secondary outcomes were respiratory failure, need for mechanical ventilation, and acute deep vein thrombosis (DVT)/pulmonary embolism (PE). Results: Of 376 patients hospitalized for COVID-19, 128 were taking aspirin. Significant proportions of native Americans were hospitalized for COVID-19 in both aspirin (22.7%) and non-aspirin (24.6%) groups. Between aspirin and non-aspirin groups, no significant differences were found with regard to mechanical ventilator support (21.1% vs. 15.3%, P = 0.16), acute cardiovascular events (7.8% vs. 5.2%, P = 0.32), acute DVT/PE (3.9% vs. 5.2%, P = 0.9), readmission rate (13.3% vs. 12.9%, P = 0.91) and mortality (23.4% vs. 20.2%, P = 0.5); however, the median duration of mechanical ventilation was significantly shorter (7 vs. 9 days, P = 0.04) and median length of hospitalization was significantly longer (5.5 vs. 4 days, P = 0.01) in aspirin group compared to non-aspirin group.
Conclusion: No significant differences were found in acute cardiovascular events, acute DVT/PE, mechanical ventilator support, and mortality rate between hospitalized COVID-19 patients who were taking aspirin compared to those not taking aspirin. However, larger studies are required to confirm our findings.
Conflict of Interest Authors have no conflict of interest to declare.
Informed Consent Informed consent was not required.
Author Contributions Poornima Vinod: writing-original draft, writing and editing, visualization, supervision, resources, project administration, methodology, investigation, data curation, and conceptualization. Vinod Krishnappa: writing-original draft, writing-review and editing, resources, investigation, data curation, and conceptualization. William Rathell: writing-original draft, writing-review and editing, resources, investigation, data curation, and conceptualization. Saira Amir: writing-review and editing, resources, investigation, data curation, and conceptualization. Subrina Sundil: writing-review and editing, resources, investigation, data curation, and conceptualization. Godwin Dogbey: statistical analysis, methodology, investigation, data curation, and conceptualization. Hiten Patel: writing-review and editing, conceptualization, and supervision. William Herzog: writingreview and editing, conceptualization, and supervision.
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