Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Mar 9, 2022; 11(2): 92-101
Published online Mar 9, 2022. doi: 10.5492/wjccm.v11.i2.92
Retrospective analysis of aspirin's role in the severity of COVID-19 pneumonia
Maya Gogtay, Yuvaraj Singh, Asha Bullappa, Jeffrey Scott
Maya Gogtay, Yuvaraj Singh, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01604, United States
Asha Bullappa, Community Medicine and Biostatistics, SS Institute of Medical Sciences, Davangere 577003, Karnataka, India
Jeffrey Scott, Department of Critical Care Medicine and Pulmonology, Reliant medical group- Saint Vincent Hospital, Worcester, MA 01604, United States
Author contributions: Gogtay M contributed to inception of study idea, data collection, statistical interpretations, and manuscript editing and final submission; Singh Y drafting manuscript, assisting with statistics, proof reading and abstract creation; Bullappa A statistical analysis of data; Scott J inception of study idea, proof reading of manuscript and mentor for the study.
Institutional review board statement: The study was reviewed and approved by the Saint Vincent- MetroWest Medical Center Institutional Review Board [(Approval No. 2020-072)].
Informed consent statement: Requirement of informed consent was waived by the Saint Vincent- MetroWest Medical Center Institutional Review Board [(Approval No. 2020-072)].
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maya Gogtay, MD, Doctor, Department of Internal Medicine, Saint Vincent Hospital, 123 Summer street, Worcester, MA 01604, United States. drgogtay@gmail.com
Received: November 18, 2021
Peer-review started: November 18, 2021
First decision: December 27, 2021
Revised: January 3, 2022
Accepted: January 20, 2022
Article in press: January 20, 2022
Published online: March 9, 2022
Abstract
BACKGROUND

Since December 2019, an outbreak of pneumonia caused by severe acute respiratory syndrome - coronavirus-2 (SARS-CoV-2) has led to a life-threatening ongoing pandemic worldwide. A retrospective study by Chow et al showed aspirin use was associated with decreased intensive care unit (ICU) admissions in hospitalized coronavirus disease 2019 (COVID-19) patients. Recently, the RECOVERY TRIAL showed no associated reductions in the 28-d mortality or the progression to mechanical ventilation of such patients. With these conflicting findings, our study was aimed at evaluating the impact of daily aspirin intake on the outcome of COVID-19 patients.

AIM

To study was aimed at evaluating the impact of daily aspirin intake on the outcome of COVID-19 patients.

METHODS

This retrospective cohort study was conducted on 125 COVID-19 positive patients. Subgroup analysis to evaluate the association of demographics and comorbidities was undertaken. The impact of chronic aspirin use was assessed on the survival outcomes, need for mechanical ventilation, and progression to ICU. Variables were evaluated using the chi-square test and multinomial logistic regression analysis.

RESULTS

125 patients were studied, 30.40% were on daily aspirin, and 69.60% were not. Cross-tabulation of the clinical parameters showed that hypertension (P = 0.004), hyperlipidemia (0.016), and diabetes mellitus (P = 0.022) were significantly associated with aspirin intake. Regression analysis for progression to the ICU, need for mechanical ventilation and survival outcomes against daily aspirin intake showed no statistical significance.

CONCLUSION

Our study suggests that daily aspirin intake has no protective impact on COVID-19 illness-associated survival outcomes, mechanical ventilation, or progression to ICU level of care.

Keywords: COVID-19, Aspirin, Intensive care unit progression, Antiplatelet, Hypercoagulability, Anti-inflammatory

Core Tip: Our study suggests that aspirin has no beneficial effects with regards to progression to intensive care unit (ICU) from the medical floors in coronavirus disease 2019 (COVID-19) positive patients. This study was conducted on the patients presenting during the early phase of the pandemic when there was little evidence on the most beneficial modality of treatment. Over the last 2 years we have learned about the pro-thrombotic nature of COVID-19. Since aspirin is a widely dispensed medication in our adult population, we questioned if its chronic use could have a preventive effect on ICU progression of patients admitted to the medical floors. However, our data analysis suggests that there was no such protective effect.