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Analysis of Prior Aspirin Treatment on in-Hospital Outcome of Geriatric COVID-19 Infected Patients

Zekri-Nechar et al., Medicina, doi:10.3390/medicina58111649
Nov 2022  
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Mortality -16% Improvement Relative Risk ICU admission -16% Aspirin  Zekri-Nechar et al.  LATE TREATMENT Is late treatment with aspirin beneficial for COVID-19? Retrospective 201 patients in Spain Higher mortality (p=0.57) and ICU admission (p=0.57), not sig. c19early.org Zekri-Nechar et al., Medicina, November 2022 Favorsaspirin Favorscontrol 0 0.5 1 1.5 2+
Retrospective 201 consecutive elderly hospitalized patients in Spain, showing higher mortality with aspirin use in unadjusted results. The aspirin group was older and had higher prevalence of hypertension and dyslipidemia. Table 1 shows the same counts for mortality and ICU, but different p values.
This study is excluded in meta analysis: unadjusted differences between groups; inconsistent data.
risk of death, 16.2% higher, RR 1.16, p = 0.57, treatment 14 of 41 (34.1%), control 47 of 160 (29.4%).
risk of ICU admission, 16.2% higher, RR 1.16, p = 0.57, treatment 14 of 41 (34.1%), control 47 of 160 (29.4%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Zekri-Nechar et al., 15 Nov 2022, retrospective, Spain, peer-reviewed, 10 authors. Contact: jjzamorano@ucm.es (corresponding author).
This PaperAspirinAll
Analysis of Prior Aspirin Treatment on in-Hospital Outcome of Geriatric COVID-19 Infected Patients
Khaoula Zekri-Nechar, José Barberán, José J Zamorano-León, María Durbán, Alcira Andrés-Castillo, Carlos Navarro-Cuellar, Antonio López-Farré, Ana López-De-Andrés, Rodrigo Jiménez-García, Carlos H Martínez-Martínez
Medicina, doi:10.3390/medicina58111649
Background and Objectives: Aspirin (ASA) is a commonly used antithrombotic drug that has been demonstrated to reduce venous thromboembolism. The aim was to analyze if geriatric COVID-19 patients undergoing a 100 mg/day Aspirin (ASA) treatment prior to hospitalization differ in hospital outcome compared to patients without previous ASA therapy. Materials and Methods: An observational retrospective study was carried out using an anonymized database including geriatric COVID-19 patients (March to April 2020) admitted to Madrid Hospitals Group. A group of COVID-19 patients were treated with low ASA (100 mg/day) prior to COVID-19 infection. Results: Geriatric ASA-treated patients were older (mean age over 70 years; n = 41), had higher frequency of hypertension and hyperlipidemia, and upon admission had higher D-dimer levels than non-ASAtreated patients (mean age over 73 years; n = 160). However, patients under ASA treatment did not show more frequent pulmonary thromboembolism (PE) than non-ASA-treated patients. ASA-treated geriatric COVID-19-infected patients in-hospital < 30 days all-cause mortality was more frequent than in non-ASA-treated COVID-19 patients. In ASA-treated COVID-19-infected geriatric patients, anticoagulant therapy with low molecular weight heparin (LMWH) significantly reduced need of ICU care, but tended to increase in-hospital < 30 days all-cause mortality. Conclusions: Prior treatment with a low dose of ASA in COVID-19-infected geriatric patients increased frequency of in-hospital < 30 days all-cause mortality, although it seemed to not increase PE frequency despite D-dimer levels upon admission being higher than in non-ASA users. In ASA-treated geriatric COVID-19-infected patients, addition of LMWH therapy reduced frequency of ICU care, but tended to increase in-hospital < 30 days all-cause mortality.
Data Availability Statement: This study was carried out using an anonymized database provided by Madrid Hospitals Group. Data are from COVID-19-infected patients admitted in their hospital net that they made kindly available to some Spanish researchers within the program: COVID-19 data saves lives in Spain. Conflicts of Interest: The authors declare that they have no conflict of interest.
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Materials and ' 'Methods: An observational retrospective study was carried out using an anonymized database ' 'including geriatric COVID-19 patients (March to April 2020) admitted to Madrid Hospitals ' 'Group. A group of COVID-19 patients were treated with low ASA (100 mg/day) prior to COVID-19 ' 'infection. Results: Geriatric ASA-treated patients were older (mean age over 70 years; n = ' '41), had higher frequency of hypertension and hyperlipidemia, and upon admission had higher ' 'D-dimer levels than non-ASA-treated patients (mean age over 73 years; n = 160). However, ' 'patients under ASA treatment did not show more frequent pulmonary thromboembolism (PE) than ' 'non-ASA-treated patients. ASA-treated geriatric COVID-19-infected patients in-hospital &lt; ' '30 days all-cause mortality was more frequent than in non-ASA-treated COVID-19 patients. In ' 'ASA-treated COVID-19-infected geriatric patients, anticoagulant therapy with low molecular ' 'weight heparin (LMWH) significantly reduced need of ICU care, but tended to increase ' 'in-hospital &lt; 30 days all-cause mortality. Conclusions: Prior treatment with a low dose of ' 'ASA in COVID-19-infected geriatric patients increased frequency of in-hospital &lt; 30 days ' 'all-cause mortality, although it seemed to not increase PE frequency despite D-dimer levels ' 'upon admission being higher than in non-ASA users. In ASA-treated geriatric COVID-19-infected ' 'patients, addition of LMWH therapy reduced frequency of ICU care, but tended to increase ' 'in-hospital &lt; 30 days all-cause mortality.</jats:p>', 'DOI': '10.3390/medicina58111649', 'type': 'journal-article', 'created': { 'date-parts': [[2022, 11, 16]], 'date-time': '2022-11-16T07:27:34Z', 'timestamp': 1668583654000}, 'page': '1649', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Analysis of Prior Aspirin Treatment on in-Hospital Outcome of Geriatric COVID-19 Infected ' 'Patients', 'prefix': '10.3390', 'volume': '58', 'author': [ {'given': 'Khaoula', 'family': 'Zekri-Nechar', 'sequence': 'first', 'affiliation': []}, {'given': 'José', 'family': 'Barberán', 'sequence': 'additional', 'affiliation': []}, {'given': 'José J.', 'family': 'Zamorano-León', 'sequence': 'additional', 'affiliation': []}, {'given': 'María', 'family': 'Durbán', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alcira', 'family': 'Andrés-Castillo', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-9869-9240', 'authenticated-orcid': False, 'given': 'Carlos', 'family': 'Navarro-Cuellar', 'sequence': 'additional', 'affiliation': []}, {'given': 'Antonio', 'family': 'López-Farré', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-5551-5181', 'authenticated-orcid': False, 'given': 'Ana', 'family': 'López-de-Andrés', 'sequence': 'additional', 'affiliation': []}, {'given': 'Rodrigo', 'family': 'Jiménez-García', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Carlos H.', 'family': 'Martínez-Martínez', 'sequence': 'additional', 'affiliation': []}], 'member': '1968', 'published-online': {'date-parts': [[2022, 11, 15]]}, 'reference': [ { 'key': 'ref_1', 'doi-asserted-by': 'crossref', 'first-page': '647917', 'DOI': '10.3389/fmed.2021.647917', 'article-title': 'Risk of Clinically Relevant Venous Thromboembolism in Critically Ill ' 'Patients With COVID-19: A Systematic Review and Meta-Analysis', 'volume': '8', 'year': '2021', 'journal-title': 'Front. 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Med.'}, { 'key': 'ref_34', 'doi-asserted-by': 'crossref', 'first-page': '1650', 'DOI': '10.1161/01.CIR.0000013777.21160.07', 'article-title': 'Aspirin-resistant thromboxane biosynthesis and the risk of myocardial ' 'infarction, stroke, or cardiovascular death in patients at high risk ' 'for cardiovascular events', 'volume': '105', 'year': '2002', 'journal-title': 'Circulation'}], 'container-title': 'Medicina', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/1648-9144/58/11/1649/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 11, 16]], 'date-time': '2022-11-16T09:38:26Z', 'timestamp': 1668591506000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/1648-9144/58/11/1649'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 11, 15]]}, 'references-count': 34, 'journal-issue': {'issue': '11', 'published-online': {'date-parts': [[2022, 11]]}}, 'alternative-id': ['medicina58111649'], 'URL': 'http://dx.doi.org/10.3390/medicina58111649', 'relation': {}, 'ISSN': ['1648-9144'], 'subject': ['General Medicine'], 'container-title-short': 'Medicina', 'published': {'date-parts': [[2022, 11, 15]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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