Does Aspirin Use Reduce the Risk of Death in COVID-19 Patients?

Using aspirin early may reduce the risk of in-hospital death in hospitalized patients with COVID-19, according to new study published in JAMA Network Open.

This observational study consisted of 112,269 hospitalized patients (median age, 63) with moderate COVID. The study enrollment period was January 2020 through September 10, 2021, and focused on patients at 64 health systems in the U.S. participating in the National Institute of Health’s National COVID Cohort Collaborative. In the population of interest, 16.1% of patients were African American, 3.8% were Asian, 52.7% were White, 5.0% were of other races and ethnicities, 22.4% were of unknown race and ethnicity. Researchers sought to assess the use of aspirin within the first day of hospitalization. The primary outcome of interest was defined as 28-day in-hospital mortality. Secondary outcomes were pulmonary embolism and deep vein thrombosis. In-hospital mortality was assessed using marginal structural Cox and logistic regression models.

According to the results,  in-hospital mortality occurred in 10.9% of patients. The researchers observed that 28-day in-hospital mortality was significantly lower in those who received aspirin (10.2% vs 11.8%; odds ratio [OR], 0.85; 95% CI, 0.79-0.92; P < .001). Also, the second outcomes of pulmonary embolism, but not deep vein thrombosis, was also significantly lower in patients who received aspirin (1.0% vs 1.4%; OR, 0.71; 95% CI, 0.56-0.90; P = .004).

Early Aspirin Use and In-Hospital Mortality in Patients With Moderate COVID-19 https://t.co/VmlBwj3x1a via @JAMANetworkOpen part of @JAMANetwork Great collaboration between @GWpublichealth @GWSMHS supported by @CTSICN

— Keith Crandall (@crandallkeith) March 24, 2022

The researchers concluded that “aspirin use in the first day of hospitalization was associated with lower odds of 28-day in-hospital mortality and PE. Important subgroups that may benefit from aspirin included patients older than 60 years and those with comorbidities. Although the composite of hemorrhagic complications was not significantly higher in the early aspirin group, aspirin’s risks must be carefully weighed before treatment. An RCT in a diverse patient population with high-risk conditions is needed to confirm our findings because our study cannot definitively establish causality.”

Outstanding contribution from my good friend and colleague Jon Chow. The COVID anti-platelet controversy continues. Timing of initiation, comorbidities, and severity of illness are likely important factors. https://t.co/59FNw00uwh

— Michael Mazzeffi (@MMazzeffi) March 24, 2022