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Pre-hospital aspirin use and patient outcomes in COVID-19: Results from the International Viral Infection and Respiratory Illness Universal Study (VIRUS)

Lal et al., Archivos de Bronconeumología, doi:10.1016/j.arbres.2022.07.017 (date from preprint), NCT04323787
May 2022  
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0 0.5 1 1.5 2+ Mortality 11% Improvement Relative Risk ICU admission 22% Progression 9% Aspirin for COVID-19  Lal et al.  Prophylaxis Is prophylaxis with aspirin beneficial for COVID-19? Retrospective 21,579 patients in the USA (February 2020 - September 2021) Lower mortality (p=0.01) and ICU admission (p<0.0001) Lal et al., Archivos de Bronconeumología, May 2022 Favors aspirin Favors control
Aspirin for COVID-19
24th treatment shown to reduce risk in August 2021
*, now known with p = 0.000087 from 73 studies, recognized in 3 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.
4,200+ studies for 70+ treatments.
Retrospective 21,579 hospitalized COVID-19 patients mostly in the USA, showing lower risk of mortality and severity with existing aspirin use.
risk of death, 11.0% lower, HR 0.89, p = 0.01, treatment 4,691, control 16,888, adjusted per study, multivariable.
risk of ICU admission, 22.0% lower, HR 0.78, p < 0.001, treatment 4,691, control 16,888, adjusted per study, multivariable.
risk of progression, 9.0% lower, HR 0.91, p = 0.02, treatment 4,691, control 16,888, adjusted per study, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lal et al., 5 May 2022, retrospective, USA, peer-reviewed, 20 authors, study period 15 February, 2020 - 30 September, 2021, trial NCT04323787 (history). Contact:
This PaperAspirinAll
Pre-hospital Aspirin Use and Patient Outcomes in COVID-19: Results from the International Viral Infection and Respiratory Illness Universal Study (VIRUS)
Amos Lal, Juan Pablo Domecq Garces, Vikas Bansal, Aysun Tekin, Simon Zec, Ashish K Khanna, Matthew A Warner, Amy B Christie, Rodrigo Cartin-Ceba, Valerie M Banner-Goodspeed, Donna Lee Armaignac, Sreekanth R Cheruku, Umamaheswara Raju, Yasir Tarabichi, Joshua L Denson, Vishakha Kumar, Allan Walkey, Karen Boman, Neha Deo, Rahul Kashyap, Ognjen Gajic
Archivos de Bronconeumología, doi:10.1016/j.arbres.2022.07.017
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Conflict of Interest
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