Abstract: medRxiv preprint doi: https://doi.org/10.1101/2021.04.28.21256261; this version posted May 2, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Aspirin and NSAID use and the risk of COVID-19 David A. Drew1,2*, Chuan-Guo Guo1,2,3*, Karla A. Lee4*, Long H. Nguyen1,2,5, Amit D. Joshi1,2, Chun-Han Lo1,2,6, Wenjie Ma1,2, Raaj S. Mehta1,2, Sohee Kwon1,2, Christina M. Astley7,8, Mingyang Song6,9, Richard Davies10, Joan Capdevila10, Mary Ni Lochlainn4, Carole H. Sudre11, Mark S. Graham11, Thomas Varsavsky11, Maria F. Gomez12, Beatrice Kennedy13, Hugo Fitipaldi12, Jonathan Wolf10, Tim D. Spector4, Sebastien Ourselin11, Claire J. Steves4, Andrew T. Chan1,2,8,14,15† Affiliations: 1 Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, U.S.A. 2 Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, U.S.A. 3 Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China 4 Department of Twin Research and Genetic Epidemiology, King’s College London, London, U.K. 5 Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A. 6 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A. 7 Division of Endocrinology and Computational Epidemiology Lab, Boston Children's Hospital and Harvard Medical School, Boston, MA, U.S.A. 8 Broad Institute of MIT and Harvard, Cambridge, MA, U.S.A. 9 Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A. 10 Zoe Global Ltd., London, U.K. 11 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, U.K. 12 Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Malmö, Sweden 13 Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden. 14 Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A. 15 Massachusetts Consortium on Pathogen Readiness *Contributed equally to this work †To whom correspondence should be addressed: Andrew T. Chan, MD, MPH, Clinical & Translational Epidemiology Unit, Massachusetts General Hospital, 100 Cambridge St. Boston, MA, 02114. achan@mgh.harvard.edu One Sentence Summary: NSAID use is not associated with COVID-19 risk. NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2021.04.28.21256261; this version posted May 2, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Abstract: Early reports raised concern that use of non-steroidal anti-inflammatory drugs (NSAIDs) may increase risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19). Users of the COVID Symptom Study smartphone application reported use of aspirin and other NSAIDs between March 24 and May 8, 2020. Users were queried daily about symptoms, COVID-19 testing, and healthcare..