Evidence map›Paper›PMID 34328635›Full record

ArticleClinical drug investigation2021

Acetylsalicylic Acid Compared with Enoxaparin for the Prevention of Thrombosis and Mechanical Ventilation in COVID-19 Patients: A Retrospective Cohort Study.

Heba Wagih Abdelwahab, Shaker Wagih Shaltout, Hazem A Sayed Ahmed, Ahmed Mahmoud Fouad, Eric Merrell, Jeffrey B Riley, Rasha Salama, Ahmed Gharib Abdelrahman, Edward Darling, Ghada Fadel and 7 more

Open access · hybridAbstract read
In one paragraph

Article in Clinical drug investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
2.4field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Review
  7. Article
  8. Article
  9. Aspirin in COVID-19: Pros and Cons.Frontiers in pharmacology · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 7 institutions in 3 countries.

Heba Wagih AbdelwahabDepartment of Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Shaker Wagih ShaltoutDepartment of Tropical Medicine, Faculty of Medicine, Port Said University, Port Fuad, Egypt.
Hazem A Sayed AhmedDepartment of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Ahmed Mahmoud FouadDepartment of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Eric MerrellDepartment of Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA.
Jeffrey B RileyDepartment of Cardiovascular Perfusion, State University of New York Upstate Medical University, Syracuse, NY, USA.
Rasha SalamaDepartment of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Ahmed Gharib AbdelrahmanDepartment of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Edward DarlingDepartment of Cardiovascular Perfusion, State University of New York Upstate Medical University, Syracuse, NY, USA.
Ghada FadelDepartment of Surgery, State University of New York Upstate Medical University, Syracuse, NY, USA.
Mohamed S A ElfarTouro College of Osteopathic Medicine, New York, NY, USA.
Khaled SabryDepartment of Orthopedic Surgery, Faculty of Medicine, Port Said University, Port Fuad, Egypt.
Jaffer ShahMedical Research Center, Kateb University, Kabul, Afghanistan. jaffer.shah@kateb.edu.af.ORCID http://orcid.org/0000-0002-8961-218X
Hossam AminDepartment of Critical Care, New York Medical College, Valhalla, NY, USA.
Gary F NiemanDepartment of Surgery, State University of New York Upstate Medical University, Syracuse, NY, USA.
Adel MishrikyDepartment of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Hani AiashDepartment of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Suez Canal University · EGSUNY Upstate Medical University · USPort Said University · EGKabul University · AFMansoura University · EGNew York Medical College · USTouro College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveLow-dose acetylsalicylic acid (ASA, aspirin) is a well-known and frequently studied drug for primary and secondary prevention of disease due to its anti-inflammatory and coagulopathic effects. COVID-19 complications are attributed to the role of thrombo-inflammation. Studies regarding the use of low-dose ASA in COVID-19 are limited. For this reason, we propose that the use of low-dose ASA may have protective effects in COVID-19-related thromboembolism and lung injury. This study was conducted to assess the efficacy of low-dose ASA compared with enoxaparin, an anticoagulant, for the prevention of thrombosis and mechanical ventilation.

methodsWe conducted a retrospective cohort study on COVID-19-confirmed hospitalized patients at the Mansoura University Quarantine Hospital, outpatients, and home-isolated patients from September to December 2020 in Mansoura governorate, Egypt. Binary logistic regression analysis was used to assess the effect of ASA compared with enoxaparin on thromboembolism, and mechanical ventilation needs.

resultsThis study included 225 COVID-19 patients. Use of ASA-only (81-162 mg orally daily) was significantly associated with reduced thromboembolism (OR 0.163, p = 0.020), but both low-dose ASA and enoxaparin, and enoxaparin-only (0.5 mg/kg subcutaneously (SC) daily as prophylactic dose or 1 mg/kg SC every 12 hours as therapeutic dose) were more protective (odds ratio [OR] 0.010, OR 0.071, respectively, p < 0.001). Neither ASA-only nor enoxaparin-only were associated with a reduction in mechanical ventilation needs. Concomitant use of low-dose ASA and enoxaparin was associated with reduced mechanical ventilation (OR 0.032, 95% CI 0.004-0.226, p = 0.001).

conclusionsLow-dose ASA-only use may reduce the incidence of COVID-19-associated thromboembolism, but the reduction may be less than that of enoxaparin-only, and both ASA and enoxaparin. Concomitant use of ASA and enoxaparin demonstrates promising results with regard to the reduction of thrombotic events, and mechanical ventilation needs.

Indexed as

COVID-19ThrombosisAnticoagulantsAspirinEnoxaparinHumansRespiration, ArtificialRetrospective StudiesSARS-CoV-2AnticoagulantsAspirinEnoxaparin

Identifiers

PMID34328635
PMCPMC8323080
OpenAlexW3186056773

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.