Use of aspirin significantly reduces the risk of death in hospitalized COVID-19 patients

Inpatients taking aspirin daily had a lower risk of ICU admission, mechanical ventilation, and death SARS-CoV-2 Virus.

Hospitalization COVID-19 (new coronavirus infection) (# If there is no character limit, add parentheses when it first appears Patients taking low doses of aspirin daily to protect against cardiovascular disease have complications compared to patients not taking aspirin, according to a new study led by researchers at the University of Maryland School of Medicine. And the risk of death was significantly lower (UMSOM).

Aspirin consumers were less likely to be placed in the intensive care unit (ICU) or connected to a ventilator and were more likely to survive the infection than inpatients who were not taking aspirin. , Research, published on October 21, 2020, journal Anesthesia and analgesiaResearchers describe cheap and readily available medicines that offer “cautious optimism” and have a well-known safety profile that may help prevent serious complications.

“This is an important finding that needs to be confirmed through randomized clinical trials,” said Jonathan Chow, MD, an assistant professor of anesthesiology at UMSOM and research leader. “If our findings are confirmed, it will make aspirin the first widely available over-the-counter drug to reduce mortality in COVID-19 patients.”

To carry out the study, Dr. Chow and his colleagues screened medical records of 412 COVID-19 patients, an average of 55 years old, who were hospitalized over the past few months for complications of the infection. They were treated at the University of Maryland Medical Center in Baltimore and three other hospitals along the East Coast. About a quarter of patients took low doses of aspirin (usually 81 milligrams) daily before or shortly after admission to manage cardiovascular disease.

Researchers found that the use of aspirin reduced the risk of wearing a ventilator by 44%, the risk of entering the ICU by 43%, and most importantly, the risk of death in the hospital by 47%. I found it to be related to a decrease. Compared to those who did not take aspirin. Patients in the aspirin group did not experience a significant increase in adverse events such as major bleeding during hospitalization.

The researchers managed several factors that could have affected the patient’s prognosis, including age, gender, obesity index, race, hypertension, and diabetes. They also described the use of beta-blockers to control heart disease, kidney disease, liver disease, and blood pressure.

COVID-19 infections increase the risk of dangerous blood clots that can form in the heart, lungs, blood vessels, and other organs. In rare cases, thrombotic complications can cause a heart attack, stroke, multiple organ failure, and even death.

Doctors often recommend low-dose daily aspirin for patients who have had a heart attack or stroke previously caused by a blood clot to prevent future blood clots. However, daily use may increase the risk of major bleeding and peptic ulcer.

“We believe that the anticoagulant effect of aspirin benefits patients with COVID-19 by preventing the formation of microclots,” said Michael A., associate professor of anesthesiology at UMSOM, co-author of the study. Dr. Mazzeffi said. “Patients diagnosed with COVID-19 are advised to consider taking aspirin daily, as long as they first check with their doctor.” For example, people at high risk of bleeding due to chronic kidney disease. He added that people who regularly take certain medications, such as steroids and anticoagulants, may not be able to take aspirin safely.

Researchers at Wake Forest School of Medicine, George Washington University School of Medicine, Northeast Georgia Health System, and Walter Reed National Military Medical Center also participated in the study.

“This study adds to the tremendous work our researchers are doing in medical school to find new treatments for COVID-19 and save patients’ lives,” said Executive Vice President of Healthcare. E. Albert Reese, MD, said. Affairs, UM Baltimore, and John Z. And Akiko K. Bowers is a prominent professor and dean of the University of Maryland School of Medicine. “Confirmation studies are needed to prove that the use of aspirin leads to better results for COVID-19, but the evidence so far is that even if patients take aspirin to prevent serious complications. It suggests that you may want to discuss with your doctor whether it is safe or not. “

Reference: “Use of aspirin is associated with mechanical ventilation, ICU admission, and reduced in-hospital mortality in COVID-19 inpatients,” Chow, Jonathan H. MD; Khanna, Ashish K. MD; Kethireddy, Shravan MD; Yamane, David MD; Levine, Andrea MD; Jackson, Amanda M. MD, MAJ, MC, USA; McCardy, Michael T. MD; Tabatabai, Ali MD; Kumar, Gagan MD; Park, Paul MD; Bengenk, Ivy RN, MPH. Menaker, Jay MD; Ahmed, Nayab MD; Glidewell, Evan MD; Presutto, Elizabeth MD; Cain, Shannon, MD; Haridasa, Naeha BS; Field, Wesley MD; Fowler, Jacob GBS; Trinh, Duy MD; Johnson, Cass Lean NBS; Cowl, Amman DO; Lee, Amanda BS; Sebastian, Kyle MD; Ulrich, Doctor of Medicine, Allison; Penha, Salvador MD, PhD; Carpenter, Ross MD; Sudhakar, Shruti MD; Uppal, Pushpinder MD; Federes, Benjamin T MD, Lieutenant, USAF, MC; Sax, Doctor of Medicine Aaron; Dahbour, Layth MD; Teeter, William MD; Kenichi Tanaka MD; Galvagno, Samuel M. DO, PhD; Herr, Daniel L. MD; Scalea, Thomas M. MD and Mazzeffi, Michael A. MD, MPH, October 21, 2020, Anesthesia and analgesia..
DOI: 10.1213 / ANE.0000000000005292