Coronavirus disease-2019 (COVID-19) is associated with hypercoagulability and increased thrombotic risk in critically ill patients. To our knowledge, no studies have evaluated whether aspirin use is associated with reduced risk of mechanical ventilation, intensive care unit (ICU) admission, and in-hospital mortality.
A retrospective, observational cohort study of adult patients admitted with COVID-19 to multiple hospitals in the United States between March 2020 and July 2020 was performed. The primary outcome was the need for mechanical ventilation. Secondary outcomes were ICU admission and in-hospital mortality. Adjusted hazard ratios (HRs) for study outcomes were calculated using Cox-proportional hazards models after adjustment for the effects of demographics and comorbid conditions.
Four hundred twelve patients were included in the study. Three hundred fourteen patients (76.3%) did not receive aspirin, while 98 patients (23.7%) received aspirin within 24 hours of admission or 7 days before admission. Aspirin use had a crude association with less mechanical ventilation (35.7% aspirin versus 48.4% nonaspirin, P = .03) and ICU admission (38.8% aspirin versus 51.0% nonaspirin, P = .04), but no crude association with in-hospital mortality (26.5% aspirin versus 23.2% nonaspirin, P = .51). After adjusting for 8 confounding variables, aspirin use was independently associated with decreased risk of mechanical ventilation (adjusted HR, 0.56, 95% confidence interval [CI], 0.37-0.85, P = .007), ICU admission (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). There were no differences in major bleeding (P = .69) or overt thrombosis (P = .82) between aspirin users and nonaspirin users.
Aspirin use may be associated with improved outcomes in hospitalized COVID-19 patients. However, a sufficiently powered randomized controlled trial is needed to assess whether a causal relationship exists between aspirin use and reduced lung injury and mortality in COVID-19 patients.
At the start of the pandemic, many physicians were avoiding use of nonsteroidal anti-inflammatory drugs like aspirin. I don’t remember why.
This was a small study, so results are not as reliable as a 2000-patient experiment. But low-dose ASA is well-tolerated and cheap.
Posted onSeptember 11, 2021|Comments Off on 9/11: An Alternative History You’ve Never Heard Of
From Ron Unz, who is smarter than you and me:
The widespread doubts about the reality of the official story provided by our government and almost universally promoted by our media has severely diminished popular faith in the credibility of those two crucial institutions, with consequences that are still very apparent in today’s highest profile issues.
Over the years, diligent researchers and courageous journalists have largely demolished the original narrative of those events, and have made a strong, perhaps even overwhelming case that the Israeli Mossad together with its American collaborators played the central role. My own reconstruction, substantially relying upon such accumulated evidence, came to such conclusions, and I am therefore republishing it….
Boo hoo waah. They “restricted” my account and wouldn’t even take the time to tell me why. LinkedIn wants a photo of a government-issued ID before they’ll communicate with me. Ef that.
Steve Parker, M.D.
Update Sept 18, 2021:
From Yahoo!News: “Rep. Jim Banks, chairman of the conservative Republican Study Committee in Congress, sent a letter Friday to Microsoft-owned LinkedIn, criticizing them for bowing down to the Chinese government by blocking the profiles of Americans who refer to the Asian superpower in a critical fashion.”
Surely my little blog isn’t on China’s rardar screen. I don’t recall posting or saying anything critical of the CCP. But if I want to, I will.
Update Oct 22, 2021:
I scanned LinkedIn’s terms-of-service “Do’s and Don’t’s.” Under Don’t:
Violate the intellectual property rights of others, including copyrights, patents, trademarks, trade secrets or other proprietary rights. For example, do not copy or distribute (except through the available sharing functionality) the posts or other content of others without their permission, which they may give by posting under a Creative Commons license;
I do often comment on what others have written or said, always (as far as I know) with attribution. To be fair to the other party, I copy and paste the pertinent passage. This is “fair use” and doesn’t require specific permission. Maybe LinkedIn disagrees.
Posted onJuly 31, 2021|Comments Off on Happy National Avocado Day!
Allison Carter, Communication Manager at Trees.com, informs me that today (July 31, 2021) is National Avocado Day. In my childhood days growing up in Oklahoma and Texas, I don’t recall eating avocados at all. I’m not sure if that’s a reflection on my parents, or if avocados weren’t readily and cheaply available then. I love them now. This graphic is from Allison:
Posted onMarch 22, 2021|Comments Off on Mediterranean Diet Lowers Parkinson’s Disease Risk for Women
Investigators studied a female Swedish population.
Women who adhere closely to a Mediterranean diet in their 30s and 40s have a lower risk of Parkinson’s disease later in life, particularly once they reach their mid-60s, a large population-based Swedish study found.The study, “Mediterranean Dietary Pattern at Middle Age and Risk of Parkinson’s Disease: A Swedish Cohort Study,” was published in the journal Movement Disorders.Diet is increasingly recognized for its potential influence on a person’s risk of several diseases. With Parkinson’s, for instance, studies have suggested that dairy products could be a risk factor for its development.
Proton pump inhibitors are widely used in the U.S. to treat esophageal reflux, ulcers, and dyspepsia. They are among the most widely prescribed drugs. You can also get them over-the-counter. Brand names include Protonix, Prilosec, and Nexium.
The study at hand defined “regular use” as at least twice per week. The study was an epidemiological one observing participants for 10-12 years. The more years of regular use, the greater risk of diabetes developing. Nearly all participants were White, so results may not apply to other ethnicities.
Note that this study doesn’t prove that PPIs cause diabetes. They just found a statistical linkage. As you know, correlation does not equal causation. We don’t know how PPIs could cause T2 diabetes. From the article:
According to the study, the possible mechanism for the association could be related to gut microbiota, as previous studies have shown that PPI use is associated with reduced diversity of gut microbiome and consistent changes in the microbiota phenotype.
If your physician recommends you take a PPI chronically, ask about alternatives.