The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysis
Background: Repurposing the use of aspirin to treat hospitalized patients with COVID-19 is a sensible approach. However, several previous studies showed conflicting results. This meta-analysis was aimed to assess the effect of aspirin on the outcome in patients with COVID-19. Methods: Systematic sea...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | Clinical Epidemiology and Global Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213398421001913 |
| _version_ | 1818969019339767808 |
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| author | Indra Wijaya Rizky Andhika Ian Huang Aga Purwiga Kevin Yonatan Budiman |
| author_facet | Indra Wijaya Rizky Andhika Ian Huang Aga Purwiga Kevin Yonatan Budiman |
| author_sort | Indra Wijaya |
| collection | DOAJ |
| description | Background: Repurposing the use of aspirin to treat hospitalized patients with COVID-19 is a sensible approach. However, several previous studies showed conflicting results. This meta-analysis was aimed to assess the effect of aspirin on the outcome in patients with COVID-19. Methods: Systematic search using relevant keywords was carried out via several electronic databases until February 21, 2021. Research studies on adults COVID-19 patients with documentation on the use of aspirin and reported our outcomes of interest were included in the analysis. Our main outcome of interest was all types of mortality, while the incidence of thrombosis and bleeding were considered as secondary outcomes. Estimated risk estimates of the included studies were then pooled using DerSimonian-Laird random-effect models regardless heterogeneity. Results: Seven studies with a total of 34,415 patients were included in this systematic review and meta-analysis. The use of aspirin was associated with a reduced risk of mortality (RR 0.56, 95% CI 0.38–0.81, P = 0.002; I2: 68%, P = 0.005). Sensitivity analysis by differentiating in-hospital (active aspirin prescription) and pre-hospital use of aspirin could significantly reduce the heterogeneity (I2: 1%, P = 0.4). Only one study reported the incidence of major bleeding between aspirin and non-aspirin users (6.1% vs. 7.6%, P = 0.61). The association between the use of aspirin and the incidence of thrombosis were contradictory in two studies. Conclusion: The use of aspirin was significantly associated with a reduced risk of mortality among patients with COVID-19. Due to limited studies, the effect of aspirin on the incidence of thrombosis and bleeding in patients with COVID-19 could not be drawn definitively. |
| first_indexed | 2024-12-20T14:13:56Z |
| format | Article |
| id | doaj.art-f4679aaf817945758256ea4fcab349d6 |
| institution | Directory Open Access Journal |
| issn | 2213-3984 |
| language | English |
| last_indexed | 2024-12-20T14:13:56Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Epidemiology and Global Health |
| spelling | doaj.art-f4679aaf817945758256ea4fcab349d62022-12-21T19:38:06ZengElsevierClinical Epidemiology and Global Health2213-39842021-10-0112100883The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysisIndra Wijaya0Rizky Andhika1Ian Huang2Aga Purwiga3Kevin Yonatan Budiman4Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia; Corresponding author.Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, IndonesiaDepartment of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, IndonesiaDepartment of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, IndonesiaDepartment of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, IndonesiaBackground: Repurposing the use of aspirin to treat hospitalized patients with COVID-19 is a sensible approach. However, several previous studies showed conflicting results. This meta-analysis was aimed to assess the effect of aspirin on the outcome in patients with COVID-19. Methods: Systematic search using relevant keywords was carried out via several electronic databases until February 21, 2021. Research studies on adults COVID-19 patients with documentation on the use of aspirin and reported our outcomes of interest were included in the analysis. Our main outcome of interest was all types of mortality, while the incidence of thrombosis and bleeding were considered as secondary outcomes. Estimated risk estimates of the included studies were then pooled using DerSimonian-Laird random-effect models regardless heterogeneity. Results: Seven studies with a total of 34,415 patients were included in this systematic review and meta-analysis. The use of aspirin was associated with a reduced risk of mortality (RR 0.56, 95% CI 0.38–0.81, P = 0.002; I2: 68%, P = 0.005). Sensitivity analysis by differentiating in-hospital (active aspirin prescription) and pre-hospital use of aspirin could significantly reduce the heterogeneity (I2: 1%, P = 0.4). Only one study reported the incidence of major bleeding between aspirin and non-aspirin users (6.1% vs. 7.6%, P = 0.61). The association between the use of aspirin and the incidence of thrombosis were contradictory in two studies. Conclusion: The use of aspirin was significantly associated with a reduced risk of mortality among patients with COVID-19. Due to limited studies, the effect of aspirin on the incidence of thrombosis and bleeding in patients with COVID-19 could not be drawn definitively.http://www.sciencedirect.com/science/article/pii/S2213398421001913AspirinAcetylsalicylic acidSARS-CoV-2COVID-19Mortality |
| spellingShingle | Indra Wijaya Rizky Andhika Ian Huang Aga Purwiga Kevin Yonatan Budiman The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysis Clinical Epidemiology and Global Health Aspirin Acetylsalicylic acid SARS-CoV-2 COVID-19 Mortality |
| title | The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysis |
| title_full | The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysis |
| title_fullStr | The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysis |
| title_full_unstemmed | The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysis |
| title_short | The effects of aspirin on the outcome of COVID-19: A systematic review and meta-analysis |
| title_sort | effects of aspirin on the outcome of covid 19 a systematic review and meta analysis |
| topic | Aspirin Acetylsalicylic acid SARS-CoV-2 COVID-19 Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2213398421001913 |
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