Tantry Udaya S, Schror Karsten, Navarese Eliano Pio, Jeong Young-Hoon, Kubica Jacek, Bliden Kevin P, Gurbel Paul A
Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, LifeBridge Health, Baltimore, MD, USA.
Department of Pharmacology and Clinical Pharmacology, Heinrich-Heine-University, Düsseldorf, Germany.
J Exp Pharmacol. 2021 Dec 7;13:957-970. doi: 10.2147/JEP.S330776. eCollection 2021.
Pharmacologic therapy options for COVID-19 should include antiviral, anti-inflammatory, and anticoagulant agents. With the limited effectiveness, currently available virus-directed therapies may have a substantial impact on global health due to continued reports of mutant variants affecting repeated waves of COVID-19 around the world.
We searched articles pertaining to aspirin, COVID-19, acute lung injury and pharmacology in PubMed and provide a comprehensive appraisal of potential use of aspirin in the management of patients with COVID-19. The scope of this article is to provide an overview of the rationale and currently available clinical evidence that supports aspirin as an effective therapeutic option in COVID-19.
Experimental and clinical evidence are available for the potential use of aspirin in patients with COVID-19.
Aspirin targets the intracellular signaling pathway that is essential for viral replication, and resultant inflammatory responses, hypercoagulability, and platelet activation. With these multiple benefits, aspirin can be a credible adjunctive therapeutic option for the treatment of COVID-19. In addition, inhaled formulation with its rapid effects may enhance direct delivery to the lung, which is the key organ damaged in COVID-19 during the critical initial course of the disease, whereas the 150-325 mg/day can be used for long-term treatment to prevent thrombotic event occurrences. Being economical and widely available, aspirin can be exploited globally, particularly in underserved communities and remote areas of the world to combat the ongoing COVID-19 pandemic.
新型冠状病毒肺炎（COVID-19）的药物治疗选择应包括抗病毒、抗炎和抗凝药物。由于不断有关于影响全球多轮COVID-19的变异毒株的报道，目前可用的针对病毒的治疗方法效果有限，可能会对全球健康产生重大影响。
我们在PubMed上搜索了与阿司匹林、COVID-19、急性肺损伤和药理学相关的文章，并对阿司匹林在COVID-19患者管理中的潜在用途进行了全面评估。本文的范围是概述支持阿司匹林作为COVID-19有效治疗选择的基本原理和当前可用的临床证据。
有实验和临床证据表明阿司匹林在COVID-19患者中具有潜在用途。
阿司匹林靶向病毒复制、炎症反应、高凝状态和血小板活化所必需的细胞内信号通路。鉴于这些多重益处，阿司匹林可以成为治疗COVID-19的可靠辅助治疗选择。此外，吸入剂型起效迅速，可能会增强对肺的直接给药，而肺是COVID-19在疾病关键初始阶段受损的关键器官，而150 - 325毫克/天可用于长期治疗以预防血栓事件的发生。阿司匹林经济且广泛可得，可在全球范围内使用，特别是在世界上服务不足的社区和偏远地区，以抗击持续的COVID-19大流行。
