Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cardiovasc Hematol Agents Med Chem. 2022;20(3):189-196. doi: 10.2174/1871525720666220401102728.
Thromboembolic events are one of the important complications in COVID-19 patients, especially in severe cases. Aspirin affects platelet function by irreversibly inhibiting cyclooxygenase activity, reducing the risk of thrombosis. The current systematic review aimed to evaluate aspirin's effectiveness in preventing pro-thrombotic states in COVID-19 hospitalized patients.
The systematic search was done in PubMed/Medline, EMBASE, and Medrxiv until September 27, 2021. The following keywords were used: "COVID-19", "SARS-CoV-2", "2019 Novel Coronavirus", "Aspirin," and "Acetylsalicylic Acid."
Twelve studies were included. In COVID-19 patients, aspirin can reduce CRP, IL-6 levels, and platelet aggregation by inhibiting thromboxane A2. It can also improve antiviral immunity by hindering the biosynthesis of prostaglandins and lipoxin. Eight out of twelve articles indicated that aspirin provided a beneficial effect on COVID-19. Most studies consider lowered mechanical ventilation needs, ICU admission, illness severity, overt thrombosis, and clinical outcomes in COVID-19 patients receiving aspirin.
Aspirin as an antiplatelet and anti-inflammatory agent may reduce the mortality rates in hospitalized patients with severe COVID-19. Further observational studies are necessary to determine the effect of aspirin on the prevention of pro-thrombotic states in hospitalized COVID- 19 patients.
血栓栓塞事件是 COVID-19 患者的重要并发症之一，尤其是在重症病例中。阿司匹林通过不可逆地抑制环氧化酶活性来影响血小板功能，从而降低血栓形成的风险。本系统评价旨在评估阿司匹林在预防 COVID-19 住院患者发生促血栓状态中的有效性。
系统检索了 PubMed/Medline、EMBASE 和 Medrxiv 数据库，检索时间截至 2021 年 9 月 27 日。使用了以下关键词：“COVID-19”、“SARS-CoV-2”、“2019 年新型冠状病毒”、“阿司匹林”和“乙酰水杨酸”。
共纳入 12 项研究。在 COVID-19 患者中，阿司匹林通过抑制血栓素 A2 来降低 CRP、IL-6 水平和血小板聚集。它还可以通过阻碍前列腺素和脂氧素的生物合成来改善抗病毒免疫。12 篇文章中有 8 篇表明阿司匹林对 COVID-19 有有益作用。大多数研究认为阿司匹林可降低 COVID-19 患者的机械通气需求、重症监护病房入院率、疾病严重程度、显性血栓形成和临床结局。
作为一种抗血小板和抗炎药物，阿司匹林可能降低重症 COVID-19 住院患者的死亡率。需要进一步的观察性研究来确定阿司匹林对预防住院 COVID-19 患者发生促血栓状态的效果。
