Evaluation of Low-Dose Aspirin use among Critically Ill Patients with COVID-19: A Multicenter Propensity Score Matched Study

被引：6

作者：

Al Harthi, Abdullah F. ^{[1
,5
]}

Aljuhani, Ohoud ^{[3
]}

Korayem, Ghazwa B. ^{[2
]}

Altebainawi, Ali F. ^{[7
]}

Alenezi, Raghdah S. ^{[6
]}

Al Harbi, Shmeylan ^{[1
,4
,5
]}

Gramish, Jawaher ^{[1
,4
,5
]}

Kensara, Raed ^{[1
,5
]}

Hafidh, Awattif ^{[3
]}

Al Enazi, Huda ^{[1
,5
]}

Alawad, Ahad ^{[2
]}

Alotaibi, Rand ^{[2
]}

Alshehri, Abdulaziz ^{[4
]}

Alhuthaili, Omar ^{[4
]}

Vishwakarma, Ramesh ^{[5
]}

Bin Saleh, Khalid ^{[1
,4
,5
]}

Alsulaiman, Thamer ^{[8
]}

Alqahtani, Rahaf Ali ^{[1
,5
]}

Hussain, Sajid ^{[5
,9
]}

Almazrou, Saja ^{[8
]}

Al Sulaiman, Khalid ^{[1
,4
,5
,10
]}

机构：

[1] King Abdul Aziz Med City, Pharmaceut Care Dept, Riyadh, Saudi Arabia

[2] Princess Nourah Bint Abdulrahman Univ, Coll Pharm, Dept Pharm Practice, Riyadh, Saudi Arabia

[3] King Abdulaziz Univ, Fac Pharm, Dept Pharm Practice, Jeddah, Saudi Arabia

[4] King Saud Bin Abdulaziz Univ Hlth Sci, Coll Pharm, Riyadh, Saudi Arabia

[5] King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia

[6] Univ Hail, Coll Pharm, Hail, Saudi Arabia

[7] Minist Hlth, Pharmaceut Care Serv, King Salman Specialist Hosp, Hail Hlth Cluster, Hail, Saudi Arabia

[8] King Faisal Specialist Hosp & Res Ctr, Family Med Dept, Riyadh, Saudi Arabia

[9] King Saud Univ, Coll Pharm, Riyadh, Saudi Arabia

[10] Saudi Crit Care Pharm Res SCAPE Platform, Riyadh, Saudi Arabia

来源：

JOURNAL OF INTENSIVE CARE MEDICINE | 2022年 / 37卷 / 09期

关键词：

COVID-19; SARS-coV-2; aspirin; critically ill; intensive care units (ICUs); 30-day mortality; in-hospital mortality; RISK-FACTORS; ASSOCIATION;

D O I：

10.1177/08850666221093229

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background Aspirin is widely used as a cardioprotective agent due to its antiplatelet and anti-inflammatory properties. The literature has assessed and evaluated its role in hospitalized COVID-19 patients. However, no data are available regarding its role in COVID-19 critically ill patients. This study aimed to evaluate the use of low-dose aspirin (81-100 mg) and its impact on outcomes in critically ill patients with COVID-19. Method A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to intensive care units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were classified into two groups based on aspirin use during ICU stay. The primary outcome was in-hospital mortality, and other outcomes were considered secondary. Propensity score matching was used (1:1 ratio) based on the selected criteria. Results A total of 1033 patients were eligible, and 352 patients were included after propensity score matching. The in-hospital mortality (HR 0.73 [0.56, 0.97], p = 0.03) was lower in patients who received aspirin during stay. Conversely, patients who received aspirin had a higher odds of major bleeding than those in the control group (OR 2.92 [0.91, 9.36], p = 0.07); however, this was not statistically significant. Additionally, subgroup analysis showed a possible mortality benefit for patients who used aspirin therapy prior to hospitalization and continued during ICU stay (HR 0.72 [0.52, 1.01], p = 0.05), but not with the new initiation of aspirin (HR 1.22 [0.68, 2.20], p = 0.50). Conclusion Continuation of aspirin therapy during ICU stay in critically ill patients with COVID-19 who were receiving it prior to ICU admission may have a mortality benefit; nevertheless, it may be associated with an increased risk of significant bleeding. Appropriate evaluation for safety versus benefits of utilizing aspirin therapy during ICU stay in COVID19 critically ill patients is highly recommended.

引用

页码：1238 / 1249

页数：12

共 28 条

[1] Rationales and uncertainties for aspirin use in COVID-19: a narrative review [J].

Ahmed, Hazem A. Sayed ;

Merrell, Eric ;

Ismail, Mansoura ;

Joudeh, Anwar, I ;

Riley, Jeffrey B. ;

Shawkat, Ahmed ;

Habeb, Hanan ;

Darling, Edward ;

Goweda, Reda A. ;

Shehata, Mohamed H. ;

Amin, Hossam ;

Nieman, Gary F. ;

Aiash, Hani .

FAMILY MEDICINE AND COMMUNITY HEALTH, 2021, 9 (02)

[2]

Alegbeleye Bamidele Johnson, 2020, Iberoam J Med, V2, P335, DOI 10.5281/zenodo.3970519

[3] Clinical characteristics and outcomes of patients with heart failure admitted to the intensive care unit with coronavirus disease 2019 (COVID-19): A multicenter cohort study [J].

Bin Saleh, Khalid ;

Hafiz, Awattif ;

Alsulaiman, Khalid ;

Aljuhani, Ohoud ;

Alharbi, Shmeylan ;

Alharbi, Aisha ;

Vishwakarma, Ramesh ;

Albekairy, Abdulkareem ;

Alkathiri, Abdulmalik ;

Alanazi, Faisal ;

Almujarri, Ghada ;

Alobathani, Seba ;

Alharbi, Yazeed ;

Zowawi, Hosam M. ;

Badreldin, Hisham A. .

AMERICAN HEART JOURNAL PLUS: CARDIOLOGY RESEARCH AND PRACTICE, 2021, 7

[4] The distinctive structure and composition of arterial and venous thrombi and pulmonary emboli [J].

Chernysh, Irina N. ;

Nagaswami, Chandrasekaran ;

Kosolapova, Sofia ;

Peshkova, Alina D. ;

Cuker, Adam ;

Cines, Douglas B. ;

Cambor, Carolyn L. ;

Litvinov, Rustem, I ;

Weisel, John W. .

SCIENTIFIC REPORTS, 2020, 10 (01)

[5] Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019 [J].

Chow, Jonathan H. ;

Khanna, Ashish K. ;

Kethireddy, Shravan ;

Yamane, David ;

Levine, Andrea ;

Jackson, Amanda M. ;

McCurdy, Michael T. ;

Tabatabai, Ali ;

Kumar, Gagan ;

Park, Paul ;

Benjenk, Ivy ;

Menaker, Jay ;

Ahmed, Nayab ;

Glidewell, Evan ;

Presutto, Elizabeth ;

Cain, Shannon ;

Haridasa, Naeha ;

Field, Wesley ;

Fowler, Jacob G. ;

Trinh, Duy ;

Johnson, Kathleen N. ;

Kaur, Aman ;

Lee, Amanda ;

Sebastian, Kyle ;

Ulrich, Allison ;

Pena, Salvador ;

Carpenter, Ross ;

Sudhakar, Shruti ;

Uppal, Pushpinder ;

Fedeles, Benjamin T. ;

Sachs, Aaron ;

Dahbour, Layth ;

Teeter, William ;

Tanaka, Kenichi ;

Galvagno, Samuel M. ;

Herr, Daniel L. ;

Scalea, Thomas M. ;

Mazzeffi, Michael A. .

ANESTHESIA AND ANALGESIA, 2021, 132 (04) :930-941

[6] RISK-FACTORS FOR GASTROINTESTINAL-BLEEDING IN CRITICALLY ILL PATIENTS [J].

COOK, DJ ;

FULLER, HD ;

GUYATT, GH ;

MARSHALL, JC ;

LEASA, D ;

HALL, R ;

WINTON, TL ;

RUTLEDGE, F ;

TODD, TJR ;

ROY, P ;

LACROIX, J ;

GRIFFITH, L ;

WILLAN, A ;

NOSEWORTHY, T ;

POWLES, P ;

OPPENHEIMER, L ;

HEWSON, J ;

LANG, J ;

LEE, H ;

GUSLITS, B ;

HEULE, M .

NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (06) :377-381

[7] Association of Aspirin Use With Major Bleeding in Patients With and Without Diabetes [J].

De Berardis, Giorgia ;

Lucisano, Giuseppe ;

D'Ettorre, Antonio ;

Pellegrini, Fabio ;

Lepore, Vito ;

Tognoni, Gianni ;

Nicolucci, Antonio .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2012, 307 (21) :2286-2294

[8] Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19 [J].

Goligher, Ewan C. ;

Bradbury, Charlotte A. ;

McVerry, Bryan J. ;

Lawler, Patrick R. ;

Berger, Jeffrey S. ;

Gong, Michelle N. ;

Carrier, Marc ;

Reynolds, Harmony R. ;

Kumar, Anand ;

Turgeon, Alexis F. ;

Kornblith, Lucy Z. ;

Kahn, Susan R. ;

Marshall, John C. ;

Kim, Keri S. ;

Houston, Brett L. ;

Derde, Lennie P. G. ;

Cushman, Mary ;

Tritschler, Tobias ;

Angus, Derek C. ;

Godoy, Lucas C. ;

McQuilten, Zoe ;

Kirwan, Bridget-Anne ;

Farkouh, Michael E. ;

Brooks, Maria M. ;

Lewis, Roger J. ;

Berry, Lindsay R. ;

Lorenzi, Elizabeth ;

Gordon, Anthony C. ;

Berry, Scott M. ;

McArthur, Colin J. ;

Neal, Matthew D. ;

Hochman, Judith S. ;

Webb, Steven A. ;

Zarychanski, Ryan ;

Ahuja, Tania ;

Al-Beidh, Farah ;

Annane, Djillali ;

Arabi, Yaseen M. ;

Aryal, Diptesh ;

Kreuziger, Lisa Baumann ;

Beane, Abi ;

Bhimani, Zahra ;

Bihari, Shailesh ;

Billett, Henny H. ;

Bond, Lindsay ;

Bonten, Marc ;

Brunkhorst, Frank ;

Buxton, Meredith ;

Buzgau, Adrian ;

Castellucci, Lana A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (09) :777-789

[9] Decreased in-hospital mortality associated with aspirin administration in hospitalized patients due to severe COVID-19 [J].

Haji Aghajani, Mohammad ;

Moradi, Omid ;

Amini, Hossein ;

Azhdari Tehrani, Hamed ;

Pourheidar, Elham ;

Rabiei, Mohammad M. ;

Sistanizad, Mohammad .

JOURNAL OF MEDICAL VIROLOGY, 2021, 93 (09) :5390-5395

[10] Management of disseminated intravascular coagulation: current insights on antithrombin and thrombomodulin treatments [J].

Hayakawa, Mineji .

OPEN ACCESS EMERGENCY MEDICINE, 2018, 10 :25-29

← 1 2 3 →