Pre-hospital antiplatelet medication use on COVID-19 disease severity

Darren Pan, Ada Ip, Serena Zhan, Isaac Wasserman, Daniel J. Snyder, Alexandra Z. Agathis, Nikhil Shamapant, Jeong Yun Yang, Akila Pai, Madhu Mazumdar, Hooman Poor

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: To evaluate the association between pre-hospitalization antiplatelet medication use and COVID-19 disease severity. Design: Retrospective cohort study. Setting: Inpatient units at The Mount Sinai Hospital. Patients: Adults age ≥18 admitted between March 1, 2020 and April 9, 2020 with confirmed COVID-19 infection with at least 28 days follow-up. Measurements: We captured baseline demographic, pre-hospitalization antiplatelet medication use, and clinical encounter data for all patients who met inclusion criteria. The primary endpoint was peak score on a 6-point modified ordinal scale (MOS), which is based on World Health Organization blueprint R&S groups, used to grade severity of illness through clinical outcomes of interest. Scores indicate the following: 1 – COVID-19 infection not requiring hospitalization, 2 – requiring hospitalization but not supplemental oxygen, 3 – hospitalization requiring supplemental oxygen, 4 – hospitalization requiring high-flow nasal cannula (HFNC) or non-invasive positive pressure ventilation (NIPPV), 5 – hospitalization requiring intubation or extracorporeal membrane oxygenation (ECMO), 6 – death. Multivariable adjusted partial proportional odds model (PPOM) was performed to examine the association between pre-hospitalization antiplatelet medication use and likelihood of each MOS score. Main Results: Of 762 people admitted with COVID-19, 239 (31.4%) used antiplatelet medications pre-hospitalization while 523 (68.6%) did not. Antiplatelet users were older and had more co-morbidities at baseline. Before adjusting for covariates, patients who used antiplatelet medications pre-hospitalization were more likely than non-users to have peak MOS score 6 (death, OR 1.75, 95% CI 1.21–2.52), peak MOS score ≥5 (intubation/ECMO or death, OR 1.4, 95% CI 1.00–1.98) and peak MOS score ≥4 (HFNC, NIPPV, intubation/ECMO or death, OR 1.40, 95% CI 1.01–1.94). On multivariable adjusted PPOM analysis controlling for 13 covariates, there were no longer any significant differences in peak MOS scores between users and non-users. Conclusions: After adjusting for covariates, pre-hospital antiplatelet use was not associated with COVID-19 severity in hospitalized patients.

Original languageEnglish
Pages (from-to)618-621
Number of pages4
JournalHeart and Lung: Journal of Acute and Critical Care
Issue number5
StatePublished - 1 Sep 2021


  • Acute lung injury
  • Antiplatelet
  • Aspirin
  • COVID-19
  • Thrombosis


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