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.
, No association of low-dose aspirin with severe COVID-19 in France: A cohort of 31.1 million people without..
, Research and Practice in Thrombosis and Haemostasis, doi:10.1002/rth2.12743
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.
Abstract: Received: 4 July 2021
| Revised: 6 April 2022 | Accepted: 20 April 2022
No association of low-dose aspirin with severe COVID-19 in
France: A cohort of 31.1 million people without cardiovascular
Jérémie Botton PhD, PharmD1
| Laura Semenzato MSc1
Julie Dupouy PhD, MD
| Rosemary Dray-Spira PhD, MD1
| Alain Weill MD1
Olivier Saint-Lary PhD, MD3
| Mahmoud Zureik PhD, MD1,3
EPI-PHARE Scientific Interest Group
in Epidemiology of Health Products,
French National Agency for the Safety of
Medicines and Health Products, French
National Health Insurance, Saint-Denis,
MSPU de Pins Justaret, University Paul
Sabatier Toulouse III, UMR 1295 Inserm
Univ. Paul Sabatier, F-31000, Toulouse,
University Paris-Saclay, UVSQ, Univ.
Paris-Sud, Inserm, Primary Care and
Prevention, CESP, Villejuif, France
Jérémie Botton, EPI-PHARE Scientific
Interest Group in Epidemiology of Health
Products, French National Agency for the
Safety of Medicines and Health Products,
French National Health Insurance,
143/147 Bd Anatole France 93285 Saint-
Denis Cedex, France.
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.
Handling Editor: Dr Suzanne Cannegieter
aspirin, COVID-19, pharmacoepidemiology, primary cardiovascular prevention, public health
Jérémie Botton and Laura Semenzato contributed equally to this work.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in
any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
© 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis
and Haemostasis (ISTH).
Res Pract Thromb Haemost. 2022;6:e12743.
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BOTTON et al.
• Aspirin at low doses has been reported to be a potential drug candidate to treat or prevent severe COVID-19.
• We built a large cohort of 31.1..
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