Aspirin and Statin in COVID19; A Case Series

Objective To present an informal case series of patients that received low-dose Aspirin (ASA) and a Statin as adjuvant therapy for COVID19. Background COVID19 is characterized by a significant inflammatory reaction contributing to multiorgan failure and death. The cytokine storm observed in COVID19 is comparable to influenza. Statins, extensively used and known to be safe, have been reported to reduce influenza pneumonia-related mortality. Furthermore, they improve endothelial function and reduce thrombosis. ASA prevents platelet aggregation and leads to clot lysis, and in combination with Statins is known to significantly decrease IL-6 levels. Methods Four consecutive patients admitted to our service in late April, received ASA and Atorvastatin. Only one case received Dexamethasone. Three patients started therapy within three days of hospitalization and one on day eight. We followed patients’ status, inflammatory markers, transaminases, LDH and radiographic findings. Results Hospital stay ranged from 10 to 21 days. The patient with the longest stay developed pulmonary emboli(PE) requiring mechanical ventilation before the introduction of ASA and Statin. Inflammatory markers decreased in all patients after therapy introduction. Three patients had a downward trending D-dimer and did not develop venous thromboembolism. D-dimer and LDH remained elevated in the patient with PE. Another patient had upward trend of LDH. Transaminases were within normal limits, and pulmonary infiltrates resolved or improved in all patients who were discharged in stable condition. Conclusion The combination of low-dose ASA and a Statin as adjuvant therapy for COVID19 may be safe and effective. This hypothesis warrants further investigation in clinical trials.