Mortality and pre‐hospitalization use of low‐dose aspirin in COVID‐19 patients with coronary artery disease

Yuan, Shuai; Chen, Peng; Li, Huaping; Chen, Chen; Wang, Feng; Wang, Dao Wen

doi:10.1111/jcmm.16198

Cited by 55 publications

(71 citation statements)

References 30 publications

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“…(Lima-Morales et al, 2021) There were 6 eligible studies that were included in this meta-analysis, comprising of 13,993 patients [Figure 1]. (Jonathan H. Chow et al, 2021;Liu et al, 2021;Meizlish et al, 2021;Merzon et al, 2021;Osborne et al, 2021;Yuan et al,…”

mentioning

confidence: 99%

Active prescription of low-dose aspirin during or prior to hospitalization and mortality in COVID-19: A systematic review and meta-analysis of adjusted effect estimates

Martha¹,

Pranata²,

Lim³

et al. 2021

International Journal of Infectious Diseases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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mentioning

confidence: 99%

Active prescription of low-dose aspirin during or prior to hospitalization and mortality in COVID-19: A systematic review and meta-analysis of adjusted effect estimates

Martha¹,

Pranata²,

Lim³

et al. 2021

International Journal of Infectious Diseases

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“…Treatment with low dose ASA for coronary artery disease, atrial fibrillation, or stroke prophylaxis confers COVID-19 protection as observed in retrospective studies [ 130 , 131 , 132 ]. Patients already on low dose ASA and having COVID-19 were significantly less likely to require admission to the intensive care unit or require use of a mechanical ventilator, and more likely to survive than patients not on ASA [ 130 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patients already on low dose ASA and having COVID-19 were significantly less likely to require admission to the intensive care unit or require use of a mechanical ventilator, and more likely to survive than patients not on ASA [ 130 ]. Based on studies specific to SARS-CoV-2, in both the prophylactic antiviral effects and effects in the treatment using ASA 75 mg po daily has been reported [ 130 , 131 , 132 ].…”

Section: Resultsmentioning

confidence: 99%

Guidelines for Reopening a Nation in a SARS-CoV-2 Pandemic: A Path Forward

Baker

Greiner

2021

Medicina

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Action, not fear, is the path forward in the coronavirus infectious disease 2019 (COVID-19) pandemic. Since early 2020, the world’s nations have faced conundrums over severe acute respiratory syndrome corona virus type 2 (SARS-CoV-2) infections resulting in COVID-19 resulting in national closures, and thus, a clear understandable plan that nations can implement is required to reopen. The healthcare benefits of reopening a nation more likely than not exceed the benefits of continued pandemic-related closure. Pandemic-related closures have resulted in countless delayed or avoided urgent care evaluations. Furthermore, routine care of acute and chronic illnesses, including evaluations, diagnoses, and treatments, has also been delayed. Isolation, loss of income, and fear have resulted in mental health conditions or exacerbated existing conditions. The magnitude of untoward ramifications is unknown and may ultimately represent an inestimable degree of danger and morbidity, and even death. Purpose. The pandemic of SARS-CoV-2 has created an atmosphere of fear of COVID-19 that has directly and indirectly injured the world’s population. Since this has resulted in increasing morbidity and mortality, creating economic chaos, and near systemic collapse of educational systems with no well described plan forward, it is the purpose of this study to provide guidelines that provide a path forward to safely open a nation. Physicians often equipped by their education, training, and experiences across disciplines are uniquely positioned to comprehend, coordinate, and teach other physicians, business owners, and municipal and government leaders from guidelines. As such, physicians may take the lead in a path forward to reopening a nation, including opening businesses, educational facilities, and religious establishments, while minimizing the risk of SARS-CoV-2 infection. Method. Reviews of the literature among the disciplines of environmental air, sanitation, social interaction, medical testing, vaccination, protection, and disease prevention and safety allowed for the conceptualization and eventual genesis of identifiable interventions which either reduce the viral load in the environment or inactivate the virus from replication. Each of the guidelines was selected based on the principle that it involved the elimination or inactivation of the viral particle. With a reduction in viral load or inactivation of replication, the implementation of these guidelines is expected to allow for reopening a nation with an increased level of safety. Results. The guidelines identified, including air exchange (ventilation), air filtration, personal protective filtering devices (masks), hand hygiene, social distancing, screening and testing, vaccines, high-risk patient protection, medical management, and adjunctive therapies, are described and referenced. Conclusions. In that the pandemic is primarily a public health issue, the path forward is best coordinated by local, regional, and national physicians. Many physicians with a breadth of experiences are uniquely positioned to coordinate the implementation of these interdisciplinary guidelines. Using these guidelines as a planned, coordinated action, not fear, is a path forward. Nations have a decision to make: closuring versus opening.

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“…16 18 A recent retrospective cohort study revealed that prehospital aspirin use in hospitalised patients with COVID-19 with established coronary artery disease was not associated with increased all-cause mortality. 45…”

Section: Secondary Prevention Of Arterial Thrombosis During Covid-19 Pandemicmentioning

confidence: 99%

Rationales and uncertainties for aspirin use in COVID-19: a narrative review

et al. 2021

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ObjectivesTo review the pathophysiology of COVID-19 disease, potential aspirin targets on this pathogenesis and the potential role of aspirin in patients with COVID-19.DesignNarrative review.SettingThe online databases PubMed, OVID Medline and Cochrane Library were searched using relevant headlines from 1 January 2016 to 1 January 2021. International guidelines from relevant societies, journals and forums were also assessed for relevance.ParticipantsNot applicable.ResultsA review of the selected literature revealed that clinical deterioration in COVID-19 is attributed to the interplay between endothelial dysfunction, coagulopathy and dysregulated inflammation. Aspirin has anti-inflammatory effects, antiplatelet aggregation, anticoagulant properties as well as pleiotropic effects on endothelial function. During the COVID-19 pandemic, low-dose aspirin is used effectively in secondary prevention of atherosclerotic cardiovascular disease, prevention of venous thromboembolism after total hip or knee replacement, prevention of pre-eclampsia and postdischarge treatment for multisystem inflammatory syndrome in children. Prehospital low-dose aspirin therapy may reduce the risk of intensive care unit admission and mechanical ventilation in hospitalised patients with COVID-19, whereas aspirin association with mortality is still debatable.ConclusionThe authors recommend a low-dose aspirin regimen for primary prevention of arterial thromboembolism in patients aged 40–70 years who are at high atherosclerotic cardiovascular disease risk, or an intermediate risk with a risk-enhancer and have a low risk of bleeding. Aspirin’s protective roles in COVID-19 associated with acute lung injury, vascular thrombosis without previous cardiovascular disease and mortality need further randomised controlled trials to establish causal conclusions.

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Mortality and pre‐hospitalization use of low‐dose aspirin in COVID‐19 patients with coronary artery disease

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 55 publications

References 30 publications

Active prescription of low-dose aspirin during or prior to hospitalization and mortality in COVID-19: A systematic review and meta-analysis of adjusted effect estimates

Active prescription of low-dose aspirin during or prior to hospitalization and mortality in COVID-19: A systematic review and meta-analysis of adjusted effect estimates

Guidelines for Reopening a Nation in a SARS-CoV-2 Pandemic: A Path Forward

Rationales and uncertainties for aspirin use in COVID-19: a narrative review

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