Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration
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Abstract
There is growing evidence that thrombotic and inflammatory pathways contribute to the severity of COVID-19. Common medications such as aspirin, that mitigate these pathways, may decrease COVID-19 mortality. This retrospective assessment was designed to quantify the correlation between pre-diagnosis aspirin and mortality for COVID-19 positive patients in our care. Data from the Veterans Health Administration national electronic health record database was utilized for the evaluation. Veterans from across the country with a first positive COVID-19 polymerase chain reaction lab result were included in the evaluation which comprised 35,370 patients from March 2, 2020 to September 13, 2020 for the 14-day mortality cohort and 32,836 patients from March 2, 2020 to August 28, 2020 for the 30-day mortality cohort. Patients were matched via propensity scores and the odds of mortality were then compared. Among COVID-19 positive Veterans, preexisting aspirin prescription was associated with a statistically and clinically significant decrease in overall mortality at 14-days (OR 0.38, 95% CI 0.32–0.46) and at 30-days (OR 0.38, 95% CI 0.33–0.45), cutting the odds of mortality by more than half. Findings demonstrated that pre-diagnosis aspirin prescription was strongly associated with decreased mortality rates for Veterans diagnosed with COVID-19. Prospective evaluation is required to more completely assess this correlation and its implications for patient care.
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SciScore for 10.1101/2020.12.13.20248147: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources To do so, the treatment and control group were matched one-to-one on the unscaled covariates of age, gender, and CAN (1-year mortality) with the RStudio “MatchIt” library (V3.6.2) using the commonly used caliper setting of 0.1. RStudiosuggested: (RStudio, RRID:SCR_000432)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected …SciScore for 10.1101/2020.12.13.20248147: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources To do so, the treatment and control group were matched one-to-one on the unscaled covariates of age, gender, and CAN (1-year mortality) with the RStudio “MatchIt” library (V3.6.2) using the commonly used caliper setting of 0.1. RStudiosuggested: (RStudio, RRID:SCR_000432)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The relative recent emergence of this pandemic highlights an important limitation of all COVID-19 assessments such as reporting of mortality occurring outside of VA facilities which may be delayed and could also underestimate the results. There are several areas that deserve additional assessment as more data becomes available. For example, sub-cohort analysis of the relative impact of different dosages of aspirin, as well as the effect of less common anticoagulation medications, will become more statistically significant over time as datasets increase in size. Importantly, as a retrospective evaluation, we cannot establish direct cause and effect, only correlation that deserves dedicated controlled trial to assess the potential of aspirin as a drug repurposing option for this population.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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SciScore for 10.1101/2020.12.13.20248147: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable The majority of both the unmatched cohorts are male, which is expected for our VA population. Table 2: Resources
Software and Algorithms Sentences Resources To do so, the treatment and control group were matched one-to-one on the unscaled covariates of age, gender, and CAN (1year mortality) with the RStudio “MatchIt” library (V3.6.2) using the commonly used caliper setting of 0.1. RStudiosuggested: (RStudio, RRID:SCR_000432)Results …
SciScore for 10.1101/2020.12.13.20248147: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable The majority of both the unmatched cohorts are male, which is expected for our VA population. Table 2: Resources
Software and Algorithms Sentences Resources To do so, the treatment and control group were matched one-to-one on the unscaled covariates of age, gender, and CAN (1year mortality) with the RStudio “MatchIt” library (V3.6.2) using the commonly used caliper setting of 0.1. RStudiosuggested: (RStudio, RRID:SCR_000432)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
The relative recent emergence of this pandemic highlights an important limitation of all COVID-19 assessments such as reporting of mortality occurring outside of VA facilities which may be delayed and could also underestimate the results. There are several areas that deserve additional assessment as more data becomes available. For example, sub-cohort analysis of the relative impact of different dosages of aspirin, as well as the effect of less common anticoagulation medications, will become more statistically significant over time as datasets increase in size. Importantly, as a retrospective evaluation, we cannot establish direct cause and effect, only correlation that deserves dedicated controlled trial to assess the potential of aspirin as a drug repurposing option for this population.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
About SciScore
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