Section of Vascular Medicine, Department of Cardiovascular Medicine; Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Vasc Med. 2021 Dec;26(6):626-632. doi: 10.1177/1358863X211012754. Epub 2021 May 19.
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is an ongoing viral pandemic marked by increased risk of thrombotic events. However, the role of platelets in the elevated observed thrombotic risk in COVID-19 and utility of antiplatelet agents in attenuating thrombosis is unknown. We aimed to determine if the antiplatelet effect of aspirin may mitigate risk of myocardial infarction, cerebrovascular accident, and venous thromboembolism in COVID-19. We evaluated 22,072 symptomatic patients tested for COVID-19. Propensity-matched analyses were performed to determine if treatment with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) affected thrombotic outcomes in COVID-19. Neither aspirin nor NSAIDs affected mortality in COVID-19. Thus, aspirin does not appear to prevent thrombosis and death in COVID-19. The mechanisms of thrombosis in COVID-19, therefore, appear distinct and the role of platelets as direct mediators of SARS-CoV-2-mediated thrombosis warrants further investigation.
由严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）是一种持续存在的病毒性大流行，其特点是血栓形成事件的风险增加。然而，血小板在 COVID-19 中观察到的升高的血栓形成风险中的作用以及抗血小板药物在减轻血栓形成中的作用尚不清楚。我们旨在确定阿司匹林的抗血小板作用是否可以减轻 COVID-19 中心肌梗死、脑血管意外和静脉血栓栓塞的风险。我们评估了 22072 例有症状的 COVID-19 检测患者。进行了倾向评分匹配分析，以确定阿司匹林或非甾体抗炎药（NSAIDs）的治疗是否会影响 COVID-19 中的血栓形成结局。阿司匹林和 NSAIDs 均未影响 COVID-19 的死亡率。因此，阿司匹林似乎不能预防 COVID-19 中的血栓形成和死亡。因此，COVID-19 中的血栓形成机制似乎不同，血小板作为 SARS-CoV-2 介导的血栓形成的直接介质的作用值得进一步研究。
