The Reply

We thank Drs Chiang and Gupta for their thoughtful comments on our paper1 relating to thromboxane A2 activation and thrombosis in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus disease 2019 [COVID-19]) infection. We share the same concerns that there may be an overwhelming activation of this pathway that could overcome the inhibitory effects of aspirin on cyclooxygenase-1 and induce the converse process of “aspirin resistance.”2 Recently Chow et al3 reported that 23.7% of hospitalized patients received antecedent aspirin and after adjustment, aspirin use was associated with decreased risk of mechanical ventilation (adjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.37-0.85, P = .0 07), admission to the intensive care unit (adjusted HR 0.57, 95% CI 0.38-0.85, P = .005), and in-hospital mortality (adjusted HR 0.53, 95% CI 0.31-0.90, P = .02).
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Letter Source Type: research