The use of aspirin for primary prevention of cardiovascular disease is associated with a lower likelihood of COVID-19 infection
Merzon et al.,
The use of aspirin for primary prevention of cardiovascular disease is associated with a lower likelihood of..,
The FEBS Journal, doi:10.1111/febs.15784
Retrospective 10,477 patients in Israel, showing lower risk of COVID-19 cases with existing aspiring use.
risk of case, 27.6% lower, RR 0.72, p = 0.04, treatment 73 of 1,621 (4.5%), control 589 of 8,856 (6.7%), NNT 47, adjusted per study, odds ratio converted to relative risk.
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risk of death, 62.4% lower, RR 0.38, p = 0.51, treatment 1 of 21 (4.8%), control 6 of 91 (6.6%), adjusted per study, odds ratio converted to relative risk.
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time to viral-, 9.6% lower, relative time 0.90, p = 0.045, treatment 73, control 589, time to 2nd negative test.
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time to viral-, 14.8% lower, relative time 0.85, p = 0.005, treatment 73, control 589, time to 1st negative test.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Merzon et al., 23 Feb 2021, retrospective, Israel, peer-reviewed, 8 authors.
Abstract: The use of aspirin for primary prevention of cardiovascular
disease is associated with a lower likelihood of COVID-19
infection
Eugene Merzon1,2, Ilan Green1,2, Shlomo Vinker1,2, Avivit Golan-Cohen1,2, Alessandro Gorohovski4,
Eva Avramovich1,3, Milana Frenkel-Morgenstern4
and Eli Magen1,5
1 Leumit Health Services, Tel-Aviv, Israel
2 Department of Family Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Israel
3 Department of Management, Bar-Ilan University, Safed, Israel
4 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
5 Medicine C Department, Clinical Immunology and Allergy Division, Barzilai University Medical Center, Ben-Gurion University of the
Negev, Ashkelon, Israel
Keywords
aspirin; COVID-19; disease likelihood; Israeli
cohort
Correspondence
M. Frenkel-Morgenstern, Azrieli Faculty of
Medicine, Bar-Ilan University, Safed, Israel
Tel: +972722644901
E-mail: milana.morgenstern@biu.ac.il
Eugene Merzon and Ilan Green contributed
equally to this article
(Received 12 November 2020, revised 18
January 2021, accepted 22 February 2021)
doi:10.1111/febs.15784
Acetylsalicylic acid (aspirin) is commonly used for primary and secondary
prevention of cardiovascular diseases. Aspirin use is associated with better
outcomes among COVID-19 positive patients. We hypothesized that the
aspirin use for primary cardiovascular disease prevention might have a protective effect on COVID-19 susceptibility and disease duration. We conducted a retrospective population-based cross-sectional study, utilizing data
from the Leumit Health Services database. The proportion of patients treated with aspirin was significantly lower among the COVID-19-positive
group, as compared to the COVID-19-negative group [73 (11.03%) vs.
1548 (15.77%); P = 0.001]. Aspirin use was associated with lower likelihood of COVID-19 infection, as compared to nonusers (adjusted OR 0.71
(95% CI, 0.52 to 0.99; P = 0.041). Aspirin users were older (68.06 12.79
vs. 56.63 12.28 years of age; P < 0.001), presented a lower BMI
(28.77 5.4 vs. 30.37 4.55; P < 0.0189), and showed higher prevalence
of hypertension (56, 76.71%), diabetes (47, 64.38%), and COPD (11,
15.07%) than the aspirin nonusers (151, 25.64%, P < 0.001; 130, 22.07%,
P < 0.001; and 43, 7.3%, P = 0.023, respectively). Moreover, COVID-19
disease duration (considered as the time between the first positive and second negative COVID-19 RT–PCR test results) among aspirin users was
significantly shorter, as compared to aspirin nonusers (19.8 7.8 vs.
21.9 7.9 P = 0.045). Among hospitalized COVID-positive patients, a
higher proportion of surviving subjects were treated with aspirin (20,
19.05%), as opposed to 1 dead subject (14.29%), although this difference
was not significant (P = 0.449). In conclusion, we observed an inverse association between the likelihood of COVID-19 infection, disease duration
and mortality, and aspirin use for primary prevention.
Abbreviations
COVID-19, coronavirus SARS-CoV-2; CVD, cardiovascular disease; LHS, Leumit Health Services; SES, socioeconomic status; STING,
stimulator of interferon genes.
The FEBS Journal 288 (2021) 5179–5189 ª 2021 Federation of European Biochemical Societies
5179
E. Merzon et al.
The use of aspirin lowers COVID-19 susceptibility
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