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0 0.5 1 1.5 2+ Mortality 59% Improvement Relative Risk Mortality (b) 60% Osborne et al. Aspirin for COVID-19 Prophylaxis Is prophylaxis with aspirin beneficial for COVID-19? PSM retrospective 13,628 patients in the USA Lower mortality with aspirin (p<0.000001) Osborne et al., PloS ONE, doi:10.1371/journal.pone.0246825 Favors aspirin Favors control
Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration
Osborne et al., PloS ONE, doi:10.1371/journal.pone.0246825
Osborne et al., Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration, PloS ONE, doi:10.1371/journal.pone.0246825
Feb 2021   Source   PDF  
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Retrospective PSM analysis of pre-existing aspirin use in the USA, showing lower mortality with treatment.
risk of death, 59.4% lower, RR 0.41, p < 0.001, treatment 272 of 6,300 (4.3%), control 661 of 6,300 (10.5%), NNT 16, odds ratio converted to relative risk, 30 days, PSM.
risk of death, 60.5% lower, RR 0.40, p < 0.001, treatment 170 of 6,814 (2.5%), control 427 of 6,814 (6.3%), NNT 27, odds ratio converted to relative risk, 14 days, PSM.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Osborne et al., 11 Feb 2021, retrospective, propensity score matching, USA, peer-reviewed, 6 authors.
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Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration
Thomas F Osborne, Zachary P Veigulis, David M Arreola, Satish M Mahajan, Eliane Röösli, Catherine M Curtin
PLOS ONE, doi:10.1371/journal.pone.0246825
There is growing evidence that thrombotic and inflammatory pathways contribute to the severity of COVID-19. Common medications such as aspirin, that mitigate these pathways, may decrease COVID-19 mortality. This retrospective assessment was designed to quantify the correlation between pre-diagnosis aspirin and mortality for COVID-19 positive patients in our care. Data from the Veterans Health Administration national electronic health record database was utilized for the evaluation. Veterans from across the country with a first positive COVID-19 polymerase chain reaction lab result were included in the evaluation which comprised 35,370 patients from March 2, 2020 to September 13, 2020 for the 14-day mortality cohort and 32,836 patients from March 2, 2020 to August 28, 2020 for the 30-day mortality cohort. Patients were matched via propensity scores and the odds of mortality were then compared. Among COVID-19 positive Veterans, preexisting aspirin prescription was associated with a statistically and clinically significant decrease in overall mortality at 14days (OR 0.38, 95% CI 0.32-0.46) and at 30-days (OR 0.38, 95% CI 0.33-0.45), cutting the odds of mortality by more than half. Findings demonstrated that pre-diagnosis aspirin prescription was strongly associated with decreased mortality rates for Veterans diagnosed with COVID-19. Prospective evaluation is required to more completely assess this correlation and its implications for patient care.
Supporting information S1 Table . The 31 medication variables utilized in the logistic regression analysis. If a unique medication was present in more than 10% of the cohort, it was included as its own variable. All other medications were grouped as "other" by drug class. This resulted in the inclusion of 31 variables across 14 separate medication classes. (DOCX) S2 Table. The variables utilized to calculate the CAN 1-year mortality model (version 2.5). (DOCX) Author Contributions Conceptualization: Thomas F. Osborne, Zachary P. Veigulis. Data curation: Zachary P. Veigulis, David M. Arreola, Satish M. Mahajan. Formal analysis: Thomas F. Osborne, Zachary P. Veigulis, David M. Arreola, Satish M. Mahajan, Eliane Ro ¨o ¨sli, Catherine M. Curtin. Investigation: Thomas F. Osborne, Zachary P. Veigulis, David M. Arreola, Satish M. Mahajan, Catherine M. Curtin. Methodology: Thomas F. Osborne, Satish M. Mahajan, Eliane Ro ¨o ¨sli, Catherine M. Curtin. Project administration: Thomas F. Osborne. Supervision: Thomas F. Osborne, Catherine M. Curtin. Validation: Zachary P. Veigulis, Eliane Ro ¨o ¨sli, Catherine M. Curtin. Writing -original draft: Thomas F. Osborne. Writing -review & editing: Zachary P. Veigulis, David M. Arreola, Satish M. Mahajan, Eliane Ro ¨o ¨sli, Catherine M. Curtin.
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Diaz, Trachtenberg, Abraham, Kosagisharaf, Aa, Aspirin Bioactivity for Prevention of Cardiovascular Injury in COVID-19, Frontiers in Cardiovascular Medicine, doi:10.3389/fcvm.2020.562708
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Osborne, Suarez, Edwards, Hernandez-Boussard, Curtin, Patient Electronic Health Records Score for Preoperative Risk Assessment Before Total Knee Arthroplasty, JBJS Open Access, doi:10.2106/JBJS.OA.19.00061
Osborne, Veigulis, Arreola, ¨o ¨sli, Curtin, Automated EHR score to predict COVID-19 outcomes at US Department of Veterans Affairs, Plos One, doi:10.1371/journal.pone.0236554
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Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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