Rationales and uncertainties for aspirin use in COVID-19: a narrative review.
Fam Med Community Health
; 9(2)2021 04.
Article
in English
| MEDLINE | ID: covidwho-1195851
ABSTRACT
OBJECTIVES:
To review the pathophysiology of COVID-19 disease, potential aspirin targets on this pathogenesis and the potential role of aspirin in patients with COVID-19.DESIGN:
Narrative review.SETTING:
The online databases PubMed, OVID Medline and Cochrane Library were searched using relevant headlines from 1 January 2016 to 1 January 2021. International guidelines from relevant societies, journals and forums were also assessed for relevance.PARTICIPANTS:
Not applicable.RESULTS:
A review of the selected literature revealed that clinical deterioration in COVID-19 is attributed to the interplay between endothelial dysfunction, coagulopathy and dysregulated inflammation. Aspirin has anti-inflammatory effects, antiplatelet aggregation, anticoagulant properties as well as pleiotropic effects on endothelial function. During the COVID-19 pandemic, low-dose aspirin is used effectively in secondary prevention of atherosclerotic cardiovascular disease, prevention of venous thromboembolism after total hip or knee replacement, prevention of pre-eclampsia and postdischarge treatment for multisystem inflammatory syndrome in children. Prehospital low-dose aspirin therapy may reduce the risk of intensive care unit admission and mechanical ventilation in hospitalised patients with COVID-19, whereas aspirin association with mortality is still debatable.CONCLUSION:
The authors recommend a low-dose aspirin regimen for primary prevention of arterial thromboembolism in patients aged 40-70 years who are at high atherosclerotic cardiovascular disease risk, or an intermediate risk with a risk-enhancer and have a low risk of bleeding. Aspirin's protective roles in COVID-19 associated with acute lung injury, vascular thrombosis without previous cardiovascular disease and mortality need further randomised controlled trials to establish causal conclusions.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Thromboembolism
/
Anti-Inflammatory Agents, Non-Steroidal
/
Aspirin
/
COVID-19
Type of study:
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
/
Reviews
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Humans
/
Middle aged
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Fmch-2020-000741
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