This is even as the Specialist Registrar/Associate Fellow in Anaesthesia & Critical Care at the Irrua Specialist Teaching Hospital, Edo State, Dr. Julian Ojebo, said a low dose of the anticoagulant aspirin could reduce the need for mechanical ventilation and admission to intensive care.

In an observational cohort study of 412 adult patients with COVID-19, aspirin use was associated with a significantly lower rate of mechanical ventilation, intensive care unit admission, and in-hospital mortality after controlling for confounding variables.

Among the 412 patients, 314 patients (76.3 percent) did not receive aspirin, while 98 patients (23.7 percent) received aspirin within 24 hours of admission or seven days before admission.

The researchers, led by Jonathan H. Chow of the Department of Anesthesiology and Critical Care, George Washington University School of Medicine, said aspirin use had a crude association with less mechanical ventilation and ICU admission, but no crude association with in-hospital mortality.

“After adjusting for eight confounding variables, aspirin use was independently associated with decreased risk of mechanical ventilation, ICU admission, and in-hospital mortality.

“There were no differences in major bleeding or overt thrombosis between aspirin users and non-aspirin users,” they said.

The researchers added that the study’s primary outcome was the need for invasive mechanical ventilation, inclusive of ventilation with an endotracheal or tracheostomy tube, and exclusive of noninvasive ventilation with continuous positive airway pressure or bilevel positive airway pressure.

“In summary, our analysis suggests that aspirin use may have beneficial effects in patients with COVID-19. Mechanistically, these findings are plausible given aspirin’s irreversible antiplatelet effect and the frequent hypercoagulability observed in COVID-19 patients.

“The results of our study are intriguing, especially because aspirin has been thoroughly studied in chronic cardiovascular disease, has a well-described safety profile, and is readily available throughout the world.

“The preliminary, hypothesis-generating nature of our study, provides the basis for a larger study, which will be needed to confirm our findings and assess the extent to which the relationships observed in our study are causal.

“Until a randomized controlled trial of aspirin is performed, it is imperative to exercise cautious optimism and deliberately balance aspirin’s known risks against its potential benefits in patients afflicted by COVID-19,” the researchers said.

Commenting on the study, Specialist Registrar/Associate Fellow in Anaesthesia & Critical Care at the Irrua Specialist Teaching Hospital, Edo State, Dr. Julian Ojebo, said a low dose of the anticoagulant aspirin could reduce the need for mechanical ventilation and admission to intensive care.

“Generally any antiplatelet can be used for hospitalised COVID-19 patient,” he said.

Antiplatelets are medicines that stop cells in the blood (platelets) from sticking together and forming a clot. A blood clot can lead to a heart attack or stroke. Aspirin is the most common antiplatelet. At a low dose, aspirin reduces inflammation in the arteries, experts say.

Continuing, Ojebo said, “We give subcutaneous low dose enoxaparin in Nigeria here and both the aspirin and the enoxaparin work.

“There are two main types of blood thinners from a layman’s perspective, which are the anticoagulants and the antiplatelet.

“Anticoagulants such as heparin or warfarin slow down the body’s process of making clots; while the antiplatelet drugs, such as aspirin, prevent blood cells [platelets] from clumping together to form a clot.”

source: Punch