Early aspirin treatment shows promise in averting death in COVID-19

Early aspirin therapy appears to reduce mortality among patients with moderate COVID-19, researchers reported on March 24, 2022 in JAMA Network Open.

“This is our third study and the culmination of 15 months of work looking at aspirin use in hospitalized COVID-19 patients,” said lead author, Jonathan Chow M.D. associate professor of anesthesiology and critical care at George Washington University in Washington, D.C. “We continue to find that aspirin use is associated with improved outcomes and lower rates of death in hospitalized patients. What’s more, it’s low cost and readily available, which is important in parts of the world where more expensive therapeutics might not be as accessible,” he added.

The investigators conducted an analysis of data on 112,269 subjects hospitalized with moderate COVID-19 from January 1, 2020 through September 10, 2020, at 64 health systems in the United States.

To be eligible for, a subject must have used aspirin use within the first day of hospitalization.

The primary outcome was 28-day in-hospital mortality. Secondary outcomes were pulmonary embolism and deep vein thrombosis.

Median age of subjects was 63 years, 16.1% were African American, 3.8% were Asian, 52.7% were White, 5.0% were of other races and ethnicities and 22.4% were of unknown race and ethnicity.

Death happened in 10.9% of the subjects. Standard statistical analysis showed that 28-day in-hospital mortality was significantly lower in those who received aspirin (10.2% vs 11.8%; P < .001).

Pulmonary embolism, but not deep vein thrombosis, appeared at a significantly lower rate in subjects treated with aspirin (1.0% vs 1.4%; P = .004).

Early aspirin did not correlate to an increased rate of gastrointestinal hemorrhage.

Elderly subjects and those with one or more comorbidities appeared to benefit from early aspirin therapy than other subgroups.

The authors concluded, “This study suggests that early aspirin use may be associated with lower odds of in-hospital mortality among hospitalized patients with moderate COVID-19; these findings warrant further study in a randomized clinical trial that includes diverse patients with cardiovascular comorbidities.”