Abstract
Abstract only Background: COVID-19 infection has been associated with a prothrombotic state. Previous studies found conflicting results regarding the association of in-hospital antiplatelet use and mortality in patients with COVID-19. The purpose of our study was to determine whether in-hospital antiplatelet use was associated with lower morbidity or mortality in patients hospitalized with COVID-19. Methods: We conducted a two-center retrospective study of 692 adult patients hospitalized from March 2020 to October 2021 with COVID-19 confirmed by RT-PCR. Groups were stratified based on in-hospital antiplatelet use. Baseline characteristics, biomarkers, and in-hospital outcomes were described. A multivariate regression model was used to estimate the association of the primary outcome of interest with in-hospital antiplatelet use. Antiplatelet use was defined as aspirin and/or P2Y12 inhibitor therapy. Statistical analyses were performed using SPSS 28. Results: Antiplatelet use was present in 40.2% (278/692) of patients. These patients were older (68 vs. 62 years old, p<0.001) and had higher rates of hypertension (74.8% vs. 59.9%, p=0.001), type 2 diabetes (48.6% vs. 34.5%, p=0.001), coronary artery disease (23% vs. 7%, p<0.001), and heart failure (19.4% vs. 8.5%, <0.001). There was no significant difference in peak d-dimer levels between groups. Patients with in-hospital antiplatelet use had lower adjusted odds ratios of venous thromboembolism (0.62 [0.40-0.95], p=0.03), ICU admission (0.69 [0.49-0.96], p=0.03), and intubation (0.62 [0.44-0.88], p=0.006). There was no difference in all-cause mortality. Conclusion: Hospitalized COVID-19 patients treated with antiplatelet therapy had more cardiovascular risk factors, yet they had lower adjusted odds of venous thromboembolism, ICU admission, and intubation. Antiplatelet therapy during hospitalization with COVID-19 was not associated with lower mortality risk.
