Abstract

INTRODUCTION: In the genesis of coronavirus disease (COVID-19), there is a process of endotheliitis associated with thrombotic changes, no studies have reported the use of acetylsalicylic acid (ASA) as a possible therapeutic approach. Statins could potentiate the ASA therapy. METHODS: This is a series of 14 cases with a laboratory-confirmed diagnosis of COVID-19. All patients underwent the ASA therapy. Those who had risk factors for vascular disease also underwent the high-potency statin therapy. When symptoms were totally or practically resolved, patients were discharged and advised to continue medications for a complementary time, according to the clinical evolution of each patient. RESULTS: The mean age of monitored patients was 48.6 years. A total of 78.6% patients presented with at least one comorbidity, which could have contributed as a risk factor for a poor prognosis in the evolution of COVID-19. Four patients had secondary bacterial infections; three patients needed hospitalization. None of the cases progress to stage III, and all patients had remission of symptoms, with 100% survival. CONCLUSIONS: the process of endothelial dysfunction in COVID-19 involves disseminated thrombosis, initially microvascular and later expansion into larger vessels. ASA could act as a secondary prophylaxis and prevent thrombosis from developing and reaching stage III of the disease. As this was a case series, we cannot provide definitive conclusions; however, this study allows us to formulate hypotheses and support clinical trials to evaluate benefits of the ASA therapy in the treatment of COVID-19.

Highlights

  • Introduction: In the genesis of coronavirus disease (COVID-19), there is a process of endotheliitis associated with thrombotic changes, no studies have reported the use of acetylsalicylic acid (ASA) as a possible therapeutic approach

  • In the genesis of COVID-19, there is a process of endotheliitis associated with thrombotic changes, but no studies have reported the use of acetylsalicylic acid (ASA), a well-known antiplatelet agent that acts by inhibiting cyclooxygenase 1 (COX-1)[4], as a possible therapeutic approach

  • Histopathological studies have shown that COVID-19 involves endothelial injury and diffuse and multisystemic endotheliitis[2,10]

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Summary

Introduction

In the genesis of coronavirus disease (COVID-19), there is a process of endotheliitis associated with thrombotic changes, no studies have reported the use of acetylsalicylic acid (ASA) as a possible therapeutic approach. ASA could act as a secondary prophylaxis and prevent thrombosis from developing and reaching stage III of the disease As this was a case series, we cannot provide definitive conclusions; this study allows us to formulate hypotheses and support clinical trials to evaluate benefits of the ASA therapy in the treatment of COVID-19. The present study is a case series of patients with mild to moderate COVID-19, who received a therapeutic approach with ASA associated or not associated with statin to treat endotheliitis and prevent thrombotic events Some studies have reported that statins play an important role in protecting the endothelium[5,6], in a manner that could potentiate the ASA therapy in COVID-19.

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