Pre-hospital antiplatelet medication use on COVID-19 disease severity

Abstract

Measurements: We captured baseline demographic, pre-hospitalization antiplatelet medication use, and clinical encounter data for all patients who met inclusion criteria. The primary endpoint was peak score on a 6point modified ordinal scale (MOS), which is based on World Health Organization blueprint R&S groups, used to grade severity of illness through clinical outcomes of interest. Scores indicate the following: 1 À COVID-19 infection not requiring hospitalization, 2 À requiring hospitalization but not supplemental oxygen, 3 À hospitalization requiring supplemental oxygen, 4 À hospitalization requiring high-flow nasal cannula (HFNC) or non-invasive positive pressure ventilation (NIPPV), 5 À hospitalization requiring intubation or extracorporeal membrane oxygenation (ECMO), 6 À death. Multivariable adjusted partial proportional odds model (PPOM) was performed to examine the association between pre-hospitalization antiplatelet medication use and likelihood of each MOS score. Main Results: Of 762 people admitted with COVID-19, 239 (31.4%) used antiplatelet medications pre-hospitalization while 523 (68.6%) did not. Antiplatelet users were older and had more co-morbidities at baseline. Before adjusting for covariates, patients who used antiplatelet medications pre-hospitalization were more likely than non-users to have peak MOS score 6 (death, OR 1.75, 95% CI 1.21À2.52), peak MOS score 5 (intubation/ECMO or death, OR 1.4, 95% CI 1.00À1.98) and peak MOS score 4 (HFNC, NIPPV, intubation/ECMO or death, OR 1.40, 95% CI 1.01À1.94). On multivariable adjusted PPOM analysis controlling for 13 covariates, there were no longer any significant differences in peak MOS scores between users and non-users. Conclusions: After adjusting for covariates, pre-hospital antiplatelet use was not associated with COVID-19 severity in hospitalized patients.

D,L-Lysine-Acetylsalicylate + Glycine (LASAG) Reduces SARS-CoV-2 Replication and Shows an Additive Effect with Remdesivir

“…In particular, several studies on the administration of ASA in COVID-19 patients show a variable picture on the outcome [38,39,[48][49][50][51][52][53][54]. On the one hand, an improvement in mechanical ventilation and in-hospital deaths [38], and on the other hand, no effect of ASA on mortality [39,48,50,51,53,54] were reported. While ASA administration was associated with a decreased risk of thrombosis, an increased risk of bleeding occurred [48].…”

Home pharmacological therapy in early COVID‐19 to prevent hospitalization and reduce mortality: Time for a suitable proposal

“…139 However, a paper reported that previous treatment with anti-platelet drugs did not reduce COVID-19 severity. 140 Actually, COVID-19 pathology is not a direct cause of platelet dysfunction but of the endothelia-platelets cross talk strongly impaired by immuno-inflammatory causes. Therefore, in our opinion, a simple therapeutic drug with both anti-inflammatory and anti-aggregating properties may be suitable to address COVID-10 in its early symptoms.…”

Comment on “Pre-hospital antiplatelet medication use on COVID-19 disease severity”

“…We avidly read the article “Pre-hospital antiplatelet medication use on COVID-19 disease severity” by Pan D et al and we sincerely commend the authors for their bodacious efforts. 1 …”

“…As denoted by multifarious research on the effects of antiplatelet medication use on COVID-19 disease, 2 we are in accord with the conclusion of the study that minimal to no association has been established between pre-hospital antiplatelet agents and severity of COVID-19 disease in hospitalized patients. 1 However, we deem it essential to state additional noteworthy points that would enhance the quality of this article and add to existing knowledge of this life-threatening morbidity.…”