In these trying times, many individuals are going above and beyond to ensure that preventative measures are being taken in order to increase the likelihood of surviving a Covid-19 diagnosis. Even with the approval and subsequent administration of vaccines, the prevalence of Covid-19 and Covid-19 related deaths are still at dangerously high levels. Pre-vaccine, many took to taking drugs such as ivermectin and hydroxychloroquine, based on unsubstantiated claims that they helped increase the odds of surviving the disease. Fast forward to today, the rapid development and administration of vaccines has certainly helped to bring the epidemic to a more manageable level, but the highly mutagenic virus continues to pose great risks to individuals, vaccinated and unvaccinated alike. The danger with Covid-19 lies not only within its role as a respiratory virus, but the effects it can have in other parts of the body, such as the heart and cardiovascular system. In fact, between 5-30% of hospitalized Covid-19 patients suffer some sort of thrombolytic event, with the more severe cases resulting in myocardial infarction and even strokes (RECOVERY collaborative group, 2021). Aspirin is a drug known for its anti-thrombolytic properties, which has been routinely used to treat cardiovascular events for decades. And so, researchers from the RECOVERY collaborative group designed a study to test the administration of aspirin to hospitalized Covid-19 patients in the UK in order to determine its efficacy in preventing a thrombolytic attack, and the overall implications related to the survival of Covid-19.
Aspirin is an anti-thrombolytic drug that prevents platelet aggregation by inhibiting the enzyme cyclooxygenase 1. Cyclooxygenase 1 functions by creating what are known as prostaglandins from the fatty acid arachidonic acid. These prostaglandins serve many roles within the body, including mediating inflammation. Furthermore, thromboxanes are a class of prostaglandins which are anti-platelet aggregation molecules, and thus are the target of inhibition of aspirin. Because of this, aspirin has long been used to reduce the likelihood of thrombolytic events in patients with cardiovascular disease or a history of heart attacks, and in fact, is one of the most commonly administered first response drugs in instances of suspected impending cardiac arrest. Based on its properties, it is not surprising that administration of aspirin to hospitalized Covid-19 patients was thought to increase the likelihood of avoiding a thrombolytic event and therefore a greater chance of survivability of Covid-19.
The RECOVERY collaborative group measured mortality over a 6-month period as a primary outcome, and time to discharge as a secondary outcome (RECOVERY collaborative group, 2021). They found that the use of aspirin resulted in a lower time to discharge during a 28 day hospital stay. They also found that there was no significant difference in overall mortality between the usual care and aspirin treated groups (RECOVERY collaborative group, 2021). The group also discovered, as expected, that administration of aspirin reduced the number of thrombolytic events in hospitalized Covid-19 patients by 4-6%. However, the instances of hemorrhagic events as a result of aspirin administration increased, due to reduced platelet aggregation. Based on the presented evidence from the RECOVERY collaborative group’s study, the administration of aspirin to treat Covid-19 should be taken as a case-by-case basis. Many have died from the cardiovascular events caused by Covid-19, and this study showed us that aspirin can reduce those events. However, individuals looking to take preventative measures by ingesting aspirin before, or during a Covid-19 diagnosis should talk to their physician about potential outcomes, and whether or not this is right for them.
References:
RECOVERY Collaborative Group. Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021 Nov 17:S0140-6736(21)01825-0. doi: 10.1016/S0140-6736(21)01825-0. Epub ahead of print. PMID: 34800427; PMCID: PMC8598213.
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