Acetylsalicylic acid in the treatment of patients with new coronavirus infection (COVID-19): pro and contra


DOI: https://dx.doi.org/10.18565/therapy.2021.10.110-120

Kokorin V.A.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Abstract. Platelets play a key role in the pathogenesis of the thrombo-inflammatory process in COVID-19. Prevention of thrombosis with antiplatelet agents can prevent the progression of the disease in patients with mild or moderate severity of COVID-19, and improve the prognosis in patients with severe course. Our aim was to search and review the published original studies on the use of acetylsalicylic acid (ASA) in outpatient and hospitalized patients with COVID-19. A keyword search was conducted in the RSCI and PubMed databases for the period from March 2020 till November 2021. We identified 28 publications dedicated to the study problem. In 10 studies, a positive effect of ASA in reducing mortality and/or the frequency of thrombotic complications in COVID-19 patients was noted, in 6 studies a neutral result was obtained and in 2 studies, the use of ASA was associated with a more severe course of the disease. Three out of four meta-analyses have shown the benefits of including ASA in the treatment regimens of patients with COVID-19. In five more studies, data were obtained on the effectiveness of prescribing ASA in combination with other drugs used to treat patients with a new coronavirus infection. Currently, the use of ASA is not recommended for the primary prevention of thrombosis and thromboembolic complications in patients with COVID-19. Nevertheless, scientific communities and health regulatory authorities recommend continuing the ongoing antiplatelet therapy with low doses of ASA for the purpose of secondary prevention of CVD in case of the infection. More selective approaches to prescribing ASA to COVID-19 patients, depending on the risk of thrombotic and hemorrhagic complications or the level of biomarkers, require further study.
Keywords: COVID-19, thrombotic complications, acetylsalicylic acid
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About the Autors

Valentin A. Kokorin, MD, associate professor of the Department of hospital therapy named after academician P.E. Lukomsky, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117198, Moscow, 1 Ostrovityanova Str. E-mail: valentinkokorin@yahoo.com


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