Use of aspirin in reduction of mortality of COVID‐19 patients: A meta‐analysis

Abstract

COVID‐19 infection, affecting every one of us from the last year. Emerging reports have indicated thromboembolism in serious cases of COVID‐19. The aspirin is useful to reduce mortality of serious patients with acute respiratory distress syndrome without COVID‐19. Thus, we have conducted a metanalysis to find out the role of aspirin in the mortality of COVID‐19 patients using RevMan 5. A total of 10 studies containing 56 696 COVID‐19 patients were found appropriate for quantitative analysis. The quality of articles was assessed using Newcastle–Ottawa scale. The fixed‐effect model was used to calculate the odds ratio with 95% confidence interval (CI). The odd ratio was found to be 0.70 [0.63, 0.77] which indicates a lesser likelihood of having death in COVID‐19 patients in aspirin group as compared with non‐aspirin group. However, no effect 0.00 [−0.04, 0.04] was observed after the exclusion of outliers. Thus, further clinical evidence is required to make valid conclusion.

Dynamic Hemostasis and Fibrinolysis Assays in Intensive Care COVID-19 Patients and Association with Thrombosis and Bleeding—A Systematic Review and a Cohort Study

“…First, a meta-analysis by Srivastava and Kumar investigated if the continuation of ASA upon hospitalization due to COVID-19 was beneficial. 41 The meta-analysis included 10 studies of which nine were retrospective and with great heterogeneity. The meta-analysis showed reduced odds ratio for death in patients receiving ASA, an effect driven by one study and disappearing after exclusion of outliers.…”

“…The meta-analysis showed reduced odds ratio for death in patients receiving ASA, an effect driven by one study and disappearing after exclusion of outliers. 41 Second, the RE-COVERY group investigated the commencement of treatment with ASA upon hospitalization due to COVID-19 in a randomized controlled trial. 42 The study included 14,892 patients allocated to receive ASA or usual treatment.…”

Aspirin and Infection: A Narrative Review

“…Since ASA is largely prescribed worldwide for the primary prevention of cardiovascular diseases, several studies retrospectively analyzed the effects of antiplatelet action of low-dose (81–100 mg/day) ASA in COVID-19. Based on this literature, a total of five systematic reviews with meta-analysis were published [ 140 , 141 , 142 , 143 , 144 ]. The most recent was conducted by Martha et al and included six studies comprising 13,993 patients [ 141 ].…”

“…However, the meta-analysis also agreed that a low certainty of evidence for the mortality-reducing effect of low-dose ASA can be assumed, mainly because of the retrospective design of the most included studies, with a possibility of relevant biases. For example, the meta-analysis included studies involving from 5 to more than 40,000 patients: only one study performed a separate meta-analysis after excluding such outliers, not confirming the effect of ASA on mortality [ 144 ].…”

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

“…No practitioner or physician would like to prescribe the sole aspirin to address the early symptoms of COVID‐19, yet aspirin might be useful in reducing the pro‐thrombotic impact of SARS‐CoV2 infection. The recent meta‐analysis performed by the Department of Pharmacology and Clinical Research, Delhi Institute of Pharmaceutical Sciences and Research (DIPSAR), New Delhi, India, reported an odd ratio (OR) = 0.70 (0.68–0.77), that is, a lesser probability to die for COVID‐19 in patients having taken aspirin respect to the control, 138 although this evidence may be criticized by the existence of outliers. The reliability of papers selected for the meta‐analysis was assessed by the Newcastle‐Ottawa scale.…”