Key result
Aspirin may reduce COVID-19 severity, ICU admissions, and overt thrombosis.
Why the study?
Thromboembolic events are important complications in hospitalized COVID-19 patients, and the effectiveness of aspirin in preventing pro-thrombotic states needed evaluation.
Does aspirin prevent pro-thrombotic states and improve clinical outcomes in hospitalized COVID-19 patients?
Systematic Review
Does aspirin prevent pro-thrombotic states and improve clinical outcomes in hospitalized COVID-19 patients?
Aspirin may provide beneficial anti-inflammatory and anti-thrombotic effects, potentially reducing mortality and severe complications in hospitalized COVID-19 patients.
May support aspirin in hospitalized COVID-19 to cut complications; extends anti-thrombotic data but requires RCT confirmation.
INTRODUCTION: Thromboembolic events are one of the important complications in COVID-19 patients, especially in severe cases. Aspirin affects platelet function by irreversibly inhibiting cyclooxygenase activity, reducing the risk of thrombosis. The current systematic review aimed to evaluate aspirin's effectiveness in preventing pro-thrombotic states in COVID-19 hospitalized patients. METHODS: The systematic search was done in PubMed/Medline, EMBASE, and Medrxiv until September 27, 2021. The following keywords were used: "COVID-19", "SARS-CoV-2", "2019 Novel Coronavirus", "Aspirin," and "Acetylsalicylic Acid." RESULTS: Twelve studies were included. In COVID-19 patients, aspirin can reduce CRP, IL-6 levels, and platelet aggregation by inhibiting thromboxane A2. It can also improve antiviral immunity by hindering the biosynthesis of prostaglandins and lipoxin. Eight out of twelve articles indicated that aspirin provided a beneficial effect on COVID-19. Most studies consider lowered mechanical ventilation needs, ICU admission, illness severity, overt thrombosis, and clinical outcomes in COVID-19 patients receiving aspirin. CONCLUSION: Aspirin as an antiplatelet and anti-inflammatory agent may reduce the mortality rates in hospitalized patients with severe COVID-19. Further observational studies are necessary to determine the effect of aspirin on the prevention of pro-thrombotic states in hospitalized COVID- 19 patients.
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Zangiabadian et al. (2022) conducted a systematic review in COVID-19. Aspirin was evaluated on Prevention of pro-thrombotic states and clinical outcomes. Aspirin provided a beneficial effect on COVID-19 in 8 out of 12 included studies, potentially lowering mechanical ventilation needs, ICU admission, illness severity, and overt thrombosis.
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