Aspirin Is Related to Worse Clinical Outcomes of COVID-19
Isaac Kim, Siyeong Yoon, Minsup Kim, Hyunil Lee, Sinhyung Park, Wonsang Kim, Soonchul Lee
Medicina, doi:10.3390/medicina57090931
Background and Objectives: Aspirin is used globally to reduce pain and inflammation; however, its effect in patients with coronavirus disease (COVID-19) is not fully investigated and remains controversial. We evaluated the association between aspirin and COVID-19 outcomes using nationwide data from the Korean National Health Insurance System. Materials and Methods: This was a retrospective observational cohort study that included 22,660 eligible patients who underwent COVID-19 testing in South Korea between 1 January-31 July 2020. We identified all aspirin users prescribed aspirin within two weeks before or after the index date. The primary outcome was positivity for the COVID-19 test, and secondary outcomes included conventional oxygen therapy, intensive care unit, mechanical ventilation, or death. We applied the propensity score matching method to reduce the possible bias originating from the differences in patients' baseline characteristics. Results: Of those eligible, 662 patients were prescribed aspirin. Among them, 136 patients were on aspirin within two weeks before diagnosis and 526 patients were on aspirin after diagnosis. The COVID-19 test positivity rate was not significantly different according to aspirin use. Aspirin use before COVID-19 was related to an increased death rate and aspirin use after COVID-19 was related to a higher risk of the conventional oxygen therapy. Conclusion: Aspirin use was associated with adverse effects in COVID-19 patients. Further studies for mechanisms are needed.
Author Contributions: I.K.: Project administration, data curation, formal analysis, writing the original draft. S.Y.: Data curation, formal analysis, writing original draft. M.K.: Data curation, formal analysis. H.L.: Manuscript review and editing. S.P.: Data curation. W.K.: Data curation. S.L.: Conceptualization, funding acquisition, investigation, methodology, manuscript review and editing. All authors have read and agreed to the published version of the manuscript.
Institutional Review Board Statement: The study protocol was approved by the Institutional Review Board (IRB) of CHA University Bundang Hospital, Korea (IRB No. CHAMC 2020-08-004) and the Health Insurance Review and Assessment Service (NHIS-2021-1-084). Informed Consent Statement: Not applicable.
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