阿司匹林对COVID-19临床结局的影响:Meta分析

Effects of Aspirin on Clinical Outcomes of COVID-19: A Meta-Analysis

目的:系统评价阿司匹林对COVID-19患者临床结局的影响。方法:计算机检索PubMed数据库,搜集阿司匹林对COVID-19患者临床结局影响的研究,检索时限为2019年12月1日至2022年10月31日,文献筛选、资料提取、纳入研究的偏倚风险评价均由2位研究员独立完成,之后采用RevMan 5.4软件进行Meta分析。结果:共纳入20个研究,包括221,263例患者。Meta分析的结果显示,阿司匹林组与对照组在COVID-19患者死亡率[OR = 1.09,95% CI为(0.93, 1.29),P = 0. 28]、进展到ICU [OR = 1.86,95% CI为(0.53, 6.60),P = 0. 33]和使用机械通气[OR = 0.94,95% CI为(0.68, 1.31),P = 0.73]、发生血栓事件[OR = 1.34,95% CI为(0.77, 2.32),P = 0. 30]、大出血事件[OR = 1.25,95% CI为(0.85, 1.83),P = 0.26]之间比较差异无统计学意义。结论:阿司匹林在降低COVID-19患者死亡率、血栓及大出血事件、进展到ICU及使用机械通气没有保护作用。由于受到纳入研究质量和数量的限制,尚需开展更多高质量研究对上述结论予以验证。

Objective: To systematically evaluate the effect of aspirin on the clinical outcome of patients with COVID-19. Methods: PubMed database was searched by computer to collect studies on the effects of aspirin on clinical outcomes of patients with COVID-19. The search period was from December 1, 2019 to October 31, 2022. Literature screening, data extraction and bias risk assessment of included studies were completed independently by two researchers. After that, RevMan 5.4 software was used for meta-analysis. Results: Twenty studies involving 221,263 patients were included. The results of meta-analysis showed that the mortality rate of patients with COVID-19 in aspirin group and control group [OR = 1.09, 95% CI (0.93, 1.29), P = 0.28], progression to ICU [OR = 1.86, 95% CI (0.53, 6.60), P = 0.33], use of mechanical ventilation [OR = 0.94, 95% CI (0.68, 1.31), P = 0.73], occurrence of thrombotic events [OR = 1.34, 95% CI (0.77, 2.32), P = 0.30], major bleeding events [OR = 1.25, 95% CI (0.85, 1.83), P = 0.26] was not statistically significant. Conclusion: Aspirin has no protective effect on mortality, thrombosis and major bleeding events, progression to ICU, and use of mechanical ventilation in patients with COVID-19. However, on account of the limitations in the quality and quantity of included studies, more high-quality studies are needed to confirm these conclusions.