Antiplatelet therapy prior to COVID-19 infection impacts on patients mortality: A propensity score-matched cohort study.

Abstract

Abstract Hyperinflammation and coagulopathy with interaction with platelets are the pathomechanisms responsible for the unfavorable outcome of COVID-19. Therefore, the role of antiplatelet therapy (AP) therapy in patients with COVID-19 is uncertain. The aim of this study was to investigate if AP has an impact on the in-hospital course and medium-term outcomes in hospitalized COVID-19 patients. The study population (2170 COVID-19 patients: 60 (19) years old, 50% male) was divided into a group of 274 patients receiving any AP prior to COVID-19 infection (AP group), and after propensity score matching, a group of 274 patients without previous AP (non-AP group). Patients from the AP group were less frequently hospitalized in the intensive care unit (9% vs. 15%, P=0.027), developed less often shock (9% vs. 15%, P=0.033), and required less aggressive forms of therapy. The AP group had more coronary revascularizations (5% vs. 1%, P=0.008) and strokes/TIA (5% vs. 1%, P=0.017). The bleeding rate was comparable (6% vs. 9%, P=0.370). The patients from the AP group had lower 3-month mortality: 31% vs. 39%, P=0.032; HR(95%CI): 0.69(0.51–0.93). The groups did not differ significantly in terms of 6-month mortality. The AP may have a beneficial impact on hospital course and mortality in COVID-19.