Hospitalised Covid 19 patients who were taking a daily low-dose
aspirin to protect against cardiovascular disease had a significantly lower
risk of complications and death compared to those who were not taking aspirin,
according to a new study led by researchers at the University of Maryland
School of Medicine (UMSOM).
Aspirin
takers were less likely to be placed in the intensive care unit (ICU) or hooked
up to a mechanical ventilator, and they were more likely to survive the
infection compared to hospitalised patients who were not taking aspirin.
The study,
published in the journal “Anaesthesia and Analgesia”, provides “cautious
optimism”, the researchers say, for an inexpensive, accessible medication with
a well-known safety profile that could help prevent severe complications.
“This is a
critical finding that needs to be confirmed through a randomized clinical
trial. If our finding is confirmed, it
would make aspirin the first widely available, over-the-counter medication to
reduce mortality in Covid-19 patients,” said study leader Jonathan Chow, MD,
Assistant Professor of Anaesthesiology at UMSOM.
To conduct
the study, Dr Chow and his colleagues culled through the medical records of 412
Covid-19 patients, age of 55 on average, who were hospitalized over the past
few months due to complications of their infection.
They were treated at the University of Maryland Medical Centre in Baltimore and
three other hospitals along the East Coast. About a quarter of the patients were taking a
daily low-dose aspirin (usually 81 milligrams) before they were admitted or
right after admission to manage their cardiovascular disease.
The
researchers found aspirin use was associated with a 44 per cent reduction in
the risk of being put on a mechanical ventilator, a 43 per cent decrease in the
risk of ICU admission, and, most importantly, a 47 per cent decrease in the
risk of dying in the hospital compared to those who were not taking aspirin. The patients in the aspirin group did not
experience a significant increase in adverse events such as major bleeding
while hospitalised.
The researchers controlled for several factors that may have played a role in a
patient’s prognosis including age, gender, body mass index, race, hypertension,
and diabetes. They also accounted for
heart disease, kidney disease, liver disease, and the use of beta blockers to
control blood pressure.
Covid-19
infections increase the risk of dangerous blood clots that can form in the
heart, lungs, blood vessels, and other organs. Complications from blood clots can, in rare
cases, cause heart attacks, strokes, and multiple organ failure as well as
death.
Doctors often
recommend daily low-dose aspirin for patients who have previously had a heart
attack or stroke caused by a blood clot to prevent future blood clots. Daily use, however, can increase the risk of
major bleeding or peptic ulcer disease.
“We believe that the blood thinning effects of aspirin provides benefits for
Covid-19 patients by preventing microclot formation,” said study co-author
Michael A. Mazzeffi, MD, Associate Professor of Anaesthesiology at UMSOM. “Patients diagnosed with Covid-19 may want to
consider taking a daily aspirin as long as they check with their doctor first,”
added Mazzeffi.
“Those at increased bleeding risk due to chronic kidney disease,
for example, or because they regularly use certain medications, like steroids
or blood thinners, may not be able to safely take aspirin”, he added.
Researchers
from Wake Forest School of Medicine, George Washington University School of
Medicine, Northeast Georgia Health System, and Walter Reed National Military
Medical Centre also participated in this study.
“This study
adds to the tremendous work our researchers are doing in the School of Medicine
to help find new treatments against Covid-19 and save patients’ lives,” said E.
Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM
Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and
Dean, University of Maryland School of Medicine.
“While confirmatory studies are needed to prove that aspirin use leads to
better outcomes in Covid-19, the evidence thus far suggests that patients may
want to discuss with their doctor whether it is safe for them to take aspirin to
manage potentially prevent serious complications,” added Reece.
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