Abstract

Background: COVID-19 induces a pro-coagulant state with thrombotic events. This meta-analysis explores the efficacy and safety of antiplatelet-based therapy in COVID-19 patients through randomized controlled trials (RCTs).
Materials and methods: A systematic literature search until March 10, 2023, identified 7 RCTs involving 23,415 inpatients. Of these, 11,891 received antiplatelet-based treatment, and 11,524 received placebo/other drugs. Statistical analysis was performed using Review Manager 5.4.
Results: The included trials involved patients with a mean age ranging from 54.3 to 62.0 years and a prevalence of hypertension ranging from 10.9 to 65.0% and coronary artery disease ranging from 3.2 to 32.7%. The pooled analysis showed no significant difference in overall mortality between groups (RR 1.0, 95% CI 0.99 – 1.01, p = 0.76). However, antiplatelet therapy significantly reduced major thrombotic events (RR 0.86, 95% CI 0.75 – 0.99, p = 0.04). Conversely, it increased major bleeding risks (RR 1.62, 95% CI 1.24 – 2.12, p = 0.0005). There was no significant difference in the incidence of invasive mechanical ventilation and respiratory death.
Conclusion: Antiplatelet therapy does not confer mortality benefit in COVID-19 patients but lowers major thrombotic events while increasing major bleeding risks. Ongoing large RCTs will provide more information on the therapeutic value of this therapy.

Author Details

Authors

• Guoying Kao¹
• Yunlin Chen²
• Jinqi Fan²

Departments

• ¹ Department of Cardiovascular Medicine, Chongqing Emergency Medical Center, Chongqing University Central Hospital, and
• ² Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Address

Jinqi Fan, MD
Department of Cardiology
The Second Affiliated Hospital of Chongqing Medical University
Chongqing Cardiac Arrhythmias Service Center
400010 Chongqing, China
Email: [email protected]

Citation