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0 0.5 1 1.5 2+ Death/intubation -4% Improvement Relative Risk Hospitalization -3% Aspirin for COVID-19  Botton et al.  Prophylaxis Is prophylaxis with aspirin beneficial for COVID-19? Retrospective 31,072,642 patients in France No significant difference in outcomes seen Botton et al., Research and Practice i.., Jun 2022 Favors aspirin Favors control

No association of low-dose aspirin with severe COVID-19 in France: A cohort of 31.1 million people without cardiovascular disease

Botton et al., Research and Practice in Thrombosis and Haemostasis, doi:10.1002/rth2.12743
Jun 2022  
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Aspirin for COVID-19
19th treatment shown to reduce risk in March 2021
*, now known with p = 0.000061 from 71 studies, recognized in 2 countries.
Lower risk for mortality and progression.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 31 million people without cardiovascular disease in France, showing no significant difference in hospitalization or combined intubation/death with low dose aspirin prophylaxis.
risk of death/intubation, 4.0% higher, HR 1.04, p = 0.18, Cox proportional hazards.
risk of hospitalization, 3.0% higher, HR 1.03, p = 0.046, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Botton et al., 17 Jun 2022, retrospective, France, peer-reviewed, 7 authors. Contact:
This PaperAspirinAll
No association of low‐dose aspirin with severe COVID‐19 in France: A cohort of 31.1 million people without cardiovascular disease
PhD Jérémie Botton, MSc Laura Semenzato, PhD Julie Dupouy, Rosemary Dray‐spira, MD Alain Weill, Olivier Saint‐lary, PhD Mahmoud Zureik
Research and Practice in Thrombosis and Haemostasis, doi:10.1002/rth2.12743
Background: Aspirin at low doses has been reported to be a potential drug candidate to treat or prevent severe coronavirus disease 2019 (COVID-19). Objectives: We aimed to explore whether low-dose aspirin used for primary cardiovascular prevention was associated with a lower risk of severe COVID-19. Method: A large cohort of patients without known cardiovascular comorbidities was constructed from the entire French population registered in national health care databases. In total, 31.1 million patients aged ≥40 years, including 1.5 million reimbursed for low-dose aspirin at least at three time points during the 6 months before the epidemic, were followed until hospitalization with a COVID-19 diagnosis or intubation/ death for hospitalized patients. Results: Cox models adjusted for age and sex showed a positive association between low-dose aspirin and the risk of hospitalization (hazard ratio [HR], 1.33; 95% confidence interval (CI), 1.29-1.37]) or death/intubation (HR, 1.40 [95% CI, 1.33-1.47]). In fully adjusted models, associations were close to null (HR, 1.03 [95% CI, 1.00-1.06] and 1.04 [95% CI, 0.98-1.10], respectively). Conclusion: There was no evidence for an effect of low-dose aspirin for primary cardiovascular prevention in reducing severe COVID-19.
AUTH O R CO NTR I B UTI O N S JB and LS contributed equally to this work, performing the analyses and preparing the first draft. JD and OSL suggested this study and provided the hypotheses. RDS, AW, and MZ supervised the work, especially the design of the study and the statistical analyses. All the authors read the manuscript, made comments, suggested modifications, and approved the final version. R EL ATI O N S H I P D I SCLOS U R E The authors declare no conflicts of interest. O RCI D Jérémie Botton https://orcid.
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