American Study Confirms That Aspirin Use Is Associated With Decreased Mortality Risk In COVID-19 Patients
: A detailed systematic review and meta-analysis study by researchers from the Michigan State University, USA has found that aspirin usage is associated with a significant reduction in overall and in-hospital mortality rates.
The current COVID-19 pandemic has so far caused more than 4.05 million deaths and far more are expected to die in coming surges.
The benefits of aspirin usage in prevention of COVID-19 mortality have not been much studied.
The study team aimed to study the relationship between aspirin use and covid-19 mortality. The team searched PubMed, MEDLINE, EMBASE, and Cochrane database for studies from January 2019 till June 6, 2021 with inclusion criteria of RCT, Cohort study, studies reporting mortality, and comparison studies on aspirin versus non-aspirin. Statistical analysis was done with Review Manager 5.4 statistical software using the inverse variance method.
study team assessed the pooled hazard ratio (HR), and 95% confidence interval using the random effect model and I-squared test was used to determine statistical heterogeneity.
The team included five retrospective cohort studies which met our inclusion criteria with total of 14065 participants in both groups. There were 6797 participants in the aspirin group and 7268 participants in the non-aspirin group.
The study findings showed that the use of aspirin was associated with 53% decrease in mortality compared to non-aspirin in patients with COVID-19 (adjusted HR 0.47, 95% CI 0.35-0.63, P< 0.001, I2= 47%). In the analysis restricted to patients hospitalized for COVID-19, the use of aspirin was associated with a 49% reduction in the risk for in-hospital mortality (adjusted HR 0.51, 95% CI 0.33-0.80, P = 0.004, I2= 39%).
The study findings showed that aspirin is associated with decrease in both overall mortality and in-hospital mortality in patients with COVID-19.
The study findings were published on a preprint server and are currently being peer reviewed. https://www.medrxiv.org/content/10.1101/2021.07.08.21260236v1
To date, although a significant proportion of COVID-19 patients remain asymptomatic or mildly symptomatic, the disease can cause severe complications in susceptible individuals, including older adults and persons with comorbidities.
A recent study concluded that in severely affected in-hospital COVID-19 patients, the estimated mortality rate of 11.5%. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920817/
Based on existing literature, the pathogenesis of severe COVID-19 is associated with immune dysfunction, excessive inflammation, hypercoagulation, and cardiopulmonary thrombosis.
Considering these observations, the researchers in the current study have hypothesized that intake of aspirin may reduce the severity of COVID-19 through its anti-inflammatory, anti-thrombotic, and immunomodulatory effects.
Out of more than 9
00 initially included studies, the scientists finally selected five studies for the final qualitative and quantitative analyses. All selected studies were retrospective cohort studies, with four were on in-hospitalized COVID-19 patients, and one was on non-hospitalized patients. Based on the Newcastle-Ottawa Scale scores, four out of five studies were high quality, and one was low quality.
Out of the final five studies, there were 6,797 participants in the aspirin group and 7,268 participants in the non-aspirin group. The pooled data from 5 studies revealed that aspirin intake is associated with a 53% reduction in all-cause mortality in COVID-19 patients. In the case of hospitalized COVID-19 patients, the analysis revealed that the use of aspirin is associated with a 49% reduction in in-hospital mortality.
This study findings highlight the potential importance of aspirin intake in reducing mortality risk among hospitalized and non-hospitalized COVID-19 patients. Apart from anti-inflammatory and anti-platelet effects, aspirin is known to have antiviral effects against seasonal and pathogenic coronaviruses, such as human coronavirus-229E and Middle East respiratory syndrome coronavirus (MERS-CoV). Moreover, aspirin has been used as one of the therapeutic interventions in COVID-19 patients.
However the current study has some limitations. Because of the non-availability of clinical trial data on aspirin, the current analysis has included only observational studies. Moreover, the majority of selected studies are single-centered studies conducted in the USA and China. Hence the findings may not be generalized to the global population.
Thailand Medical News had been reporting about the usage of aspirin to possibly help with the treatment of COVId-19 since May 2020.
A questionable Indian publication written by an unqualified Indian journalist wrote in March 2020 that the usage of Aspirin to possibly treat COVID-19 was fake news.
It should be noted that journalism standards and fact checkers in India are basically of a sub-standard level. The same goes for the quality of their research studies, researchers and medical journals published in India. It is no wonder that many got infected and died in India during the last COVID-19 surge and many more are expected in future surges due to the sub-standards of the media and even medical industry in the country.
Note: Do not attempt to self-prescribe or self-treat with aspirin without consulting a licensed medical doctor. Consuming aspirin with certain underlying health conditions and long term usage of aspirin can result in fatal conditions.
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