Efficacy and safety of antiplatelet agents in patients with COVID-19 a systematic review and meta-analysis of observational studies

Abstract Coagulopathy and thrombotic events have been reported in patients with coronavirus disease 2019 (COVID-19) frequently. However, the use of antiplatelet agents in COVID-19 is yet to be investigated. This article systematically reviewed the relationship between use of antiplatelet agents and major outcomes of COVID-19 patients. In total, 12 studies met our eligibility criteria. Due to high heterogeneity, we excluded three studies with high risk of bias. The result showed that antiplatelet therapy did not related to a higher mortality of COVID-19 patients (OR=1.01, 95% CI=0.77-1.33, I2=0%, P=0.88). However, the use of antiplatelet agents was associated with a lower risk of ICU admission (OR=0.63, 95% CI= 0.40-0.98, I2=0%, P=0.68) and mechanical ventilation (OR=0.57, 95% CI= 0.38-0.85, I2=0%, P=0.75) compared with those without antiplatelets. In conclusion, current results did not support that antiplatelets will cause greater mortality in patients with COVID-19 infection. Antiplatelet agents should be continued in COVID-19 patients, unless clinically indicated.