Question: Coronavirus disease 2019 (COVID-19) is associated with hypercoagulability and increased thrombotic risk. What is the impact of prehospital antiplatelet therapy on in-hospital mortality?
Findings: In-hospital mortality was significantly lower in patients receiving prehospital antiplatelet therapy, resulting in a 2.6% absolute reduction in mortality. On average, 39 patients needed to be treated to prevent one in-hospital death. In the antiplatelet therapy group, there was a significantly lower rate of pulmonary embolism and higher rate of epistaxis.
Meaning: In the largest observational study to date of prehospital antiplatelet therapy in patients with COVID-19, there was an association with significantly lower in-hospital mortality. Randomized controlled trials in diverse patient populations with high rates of baseline comorbidities are needed to determine the ultimate utility of antiplatelet therapy in COVID-19.