Department of Cardiology, Chengdu First People's Hospital, Chengdu, Sichuan, China.
Department of Nephrology, Chengdu First People's Hospital, Chengdu, Sichuan, China.
Am J Emerg Med. 2021 May;43:27-30. doi: 10.1016/j.ajem.2021.01.016. Epub 2021 Jan 13.
Despite the rationale that early anti-platelet would lower the risk of major organ dysfunction, the effectiveness of this approach remains controversial. Therefore, we perform a systematic review and meta-analysis to investigate the effect of antiplatelet treatments on patients with COVID-19 infection. An electronic search was carried out in Pubmed, Embase, Cochrane library, Web of Science, MEDLINE, Wanfang and China National Knowledge Infrastructure (CNKI). Meta-analysis and statistical analyses were completed with using the RevMan 5.3 and Stata 12.0. A total of 9 articles representing data from 5970 participants were included in this study. The meta-analysis showed antiplatelet agents were not associated with higher risk of severe COVID-19 disease (OR = 0.98, 95%CI: 0.64 to 1.50, P = 0.94; I 2 = 65%), while an adjusted analysis indicated that antiplatelet agents was not associated with an increased risk of mortality (OR = 0.65, 95%CI: 0.40 to 1.06, P = 0.498; I 2 = 0%). The results of this study reveal that while there is no significant benefit on mortality demonstrated with the use of antiplatelet agents, the upper bound of the confidence interval suggests that there is unlikely to be a compelling risk of harm associated with this practice. The benefit and risk of the use of antiplatelet agents should be fully considered especially in the presence of thrombocytopenia status in patients with COVID-19.
尽管早期使用抗血小板药物可以降低主要器官功能障碍的风险,但这种方法的有效性仍存在争议。因此,我们进行了系统评价和荟萃分析,以调查抗血小板治疗对 COVID-19 感染患者的影响。我们在 Pubmed、Embase、Cochrane 图书馆、Web of Science、MEDLINE、万方和中国国家知识基础设施(CNKI)上进行了电子检索。使用 RevMan 5.3 和 Stata 12.0 完成荟萃分析和统计分析。共有 9 篇文章代表了来自 5970 名参与者的数据,纳入了本研究。荟萃分析显示,抗血小板药物与严重 COVID-19 疾病的风险增加无关(OR=0.98,95%CI:0.64 至 1.50,P=0.94;I 2=65%),而调整分析表明,抗血小板药物与死亡率增加无关(OR=0.65,95%CI:0.40 至 1.06,P=0.498;I 2=0%)。本研究结果表明,虽然使用抗血小板药物在死亡率方面没有显著获益,但置信区间的上限表明,这种治疗方法不太可能存在明显的风险。在 COVID-19 患者存在血小板减少症的情况下,应充分考虑抗血小板药物的使用获益和风险。