Department of Epidemiology and Health Statistics, School of Public, Health Anhui Medical University, No. 81 Meishan Road, 230032, Anhui, People's Republic of China.
AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA.
Eur J Clin Pharmacol. 2022 Sep;78(9):1403-1420. doi: 10.1007/s00228-022-03356-5. Epub 2022 Jun 22.
The coronavirus disease 2019 (COVID-19) pandemic has shown unprecedented impact world-wide since the eruption in late 2019. Importantly, emerging reports suggest an increased risk of thromboembolism development in patients with COVID-19. Meanwhile, it is found that aspirin reduced mortality in critically ill patients with non-COVID-19 acute respiratory distress syndrome. Therefore, a meta-analysis was performed to investigate the effects of aspirin on COVID-19 mortality.
A systematic literature search was conducted in 10 electronic databases and 4 registries. Random effects models were used to calculate pooled relative risks (RRs) with 95% confidence intervals (Cis) to estimate the effect of aspirin on COVID-19 mortality. Relevant subgroup analyses and sensitivity analyses were also performed.
The results showed that aspirin use was associated with a reduction in COVID-19 mortality (adjusted RR 0.69; 95% CI 0.50-0.95; P < 0.001). Subgroup analysis found that the low-dose group was associated with a reduced COVID-19 mortality (adjusted RR 0.64; 95% CI 0.48-0.85; P < 0.01). Aspirin use was associated with reduced COVID-19 mortality in Europe and America (crude RR 0.71; 95% CI 0.52-0.98; P = 0.04), and results from cohort studies suggested that aspirin use was a protective factor for COVID-19 mortality (adjusted RR 0.73; 95% CI 0.52-0.99; P = 0.04). Meanwhile, aspirin use was not associated with bleeding risk (crude RR 1.22; 95% CI 0.80-1.87; P = 0.96).
This meta-analysis found that aspirin use was associated with a reduction in mortality in patients with COVID-19 and not with an increased risk of bleeding.
自 2019 年末爆发以来，2019 年冠状病毒病（COVID-19）大流行对全球造成了前所未有的影响。重要的是，新出现的报告表明 COVID-19 患者发生血栓栓塞的风险增加。同时，发现阿司匹林可降低非 COVID-19 急性呼吸窘迫综合征重症患者的死亡率。因此，进行了一项荟萃分析，以研究阿司匹林对 COVID-19 死亡率的影响。
在 10 个电子数据库和 4 个注册中心进行了系统的文献检索。使用随机效应模型计算合并的相对风险（RR）及其 95％置信区间（CI），以估计阿司匹林对 COVID-19 死亡率的影响。还进行了相关的亚组分析和敏感性分析。
结果表明，阿司匹林的使用与 COVID-19 死亡率的降低有关（调整后的 RR 0.69；95％CI 0.50-0.95；P<0.001）。亚组分析发现，低剂量组与 COVID-19 死亡率降低有关（调整后的 RR 0.64；95％CI 0.48-0.85；P<0.01）。阿司匹林的使用与欧洲和美洲的 COVID-19 死亡率降低有关（未调整的 RR 0.71；95％CI 0.52-0.98；P=0.04），并且队列研究的结果表明阿司匹林的使用是 COVID-19 死亡率的保护因素（调整后的 RR 0.73；95％CI 0.52-0.99；P=0.04）。同时，阿司匹林的使用与出血风险无关（未调整的 RR 1.22；95％CI 0.80-1.87；P=0.96）。
这项荟萃分析发现，阿司匹林的使用与 COVID-19 患者死亡率的降低有关，而与出血风险的增加无关。
