Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration

DOI record: { "DOI": "10.1371/journal.pone.0246825", "ISSN": [ "1932-6203" ], "URL": "http://dx.doi.org/10.1371/journal.pone.0246825", "abstract": "<jats:p>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 14-days (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.</jats:p>", "author": [ { "ORCID": "http://orcid.org/0000-0002-8896-2487", "affiliation": [], "authenticated-orcid": true, "family": "Osborne", "given": "Thomas F.", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0002-9026-1604", "affiliation": [], "authenticated-orcid": true, "family": "Veigulis", "given": "Zachary P.", "sequence": "additional" }, { "affiliation": [], "family": "Arreola", "given": "David M.", "sequence": "additional" }, { "affiliation": [], "family": "Mahajan", "given": "Satish M.", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-0557-6239", "affiliation": [], "authenticated-orcid": true, "family": "Röösli", "given": "Eliane", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-0850-9277", "affiliation": [], "authenticated-orcid": true, "family": "Curtin", "given": "Catherine M.", "sequence": "additional" } ], "container-title": "PLOS ONE", "container-title-short": "PLoS ONE", "content-domain": { "crossmark-restriction": false, "domain": [ "www.plosone.org" ] }, "created": { "date-parts": [ [ 2021, 2, 12 ] ], "date-time": "2021-02-12T00:02:01Z", "timestamp": 1613088121000 }, "deposited": { "date-parts": [ [ 2021, 2, 12 ] ], "date-time": "2021-02-12T00:02:42Z", "timestamp": 1613088162000 }, "editor": [ { "affiliation": [], "family": "den Uil", "given": "Corstiaan", "sequence": "first" } ], "indexed": { "date-parts": [ [ 2024, 4, 8 ] ], "date-time": "2024-04-08T19:57:15Z", "timestamp": 1712606235053 }, "is-referenced-by-count": 74, "issue": "2", "issued": { "date-parts": [ [ 2021, 2, 11 ] ] }, "journal-issue": { "issue": "2", "published-online": { "date-parts": [ [ 2021, 2, 11 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/publicdomain/zero/1.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 2, 11 ] ], "date-time": "2021-02-11T00:00:00Z", "timestamp": 1613001600000 } } ], "link": [ { "URL": "https://dx.plos.org/10.1371/journal.pone.0246825", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "340", "original-title": [], "page": "e0246825", "prefix": "10.1371", "published": { "date-parts": [ [ 2021, 2, 11 ] ] }, "published-online": { "date-parts": [ [ 2021, 2, 11 ] ] }, "publisher": "Public Library of Science (PLoS)", "reference": [ { "article-title": "Reinventing VA health care: systematizing quality improvement and quality innovation", "author": "KW Kizer", "first-page": "I7", "journal-title": "Medical care", "key": "pone.0246825.ref001", "volume": "2000", "year": "2000" }, { "author": "JZ Wang", "key": "pone.0246825.ref002", "volume-title": "Main results report, prepared for Strategic Analysis Service (SAS) Office of Strategic Planning and Analysis (OSPA) Veterans Health Administration", "year": "2019" }, { "key": "pone.0246825.ref003", "unstructured": "About VHA. Washington, DC: Veterans Health Administration, July 2019. (https://www.va.gov/health/aboutvha.asp). Accessed May 1, 2020" }, { "DOI": "10.1136/bmjdrc-2020-001343", "article-title": "Clinical characteristics and outcomes of patients with severe covid-19 with diabetes", "author": "Y Yan", "doi-asserted-by": "crossref", "first-page": "e001343", "journal-title": "BMJ Open Diabetes Research and Care", "key": "pone.0246825.ref004", "volume": "8", "year": "2020" }, { "DOI": "10.1001/jama.2020.4326", "article-title": "Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State", "author": "M Arentz", "doi-asserted-by": "crossref", "first-page": "1612", "issue": "16", "journal-title": "Jama", "key": "pone.0246825.ref005", "volume": "323", "year": "2020" }, { "DOI": "10.2106/JBJS.OA.19.00061", "article-title": "Patient Electronic Health Records Score for Preoperative Risk Assessment Before Total Knee Arthroplasty", "author": "TF Osborne", "doi-asserted-by": "crossref", "first-page": "e0061", "journal-title": "JBJS Open Access", "key": "pone.0246825.ref006", "volume": "5", "year": "2020" }, { "article-title": "Automated EHR score to predict COVID-19 outcomes at US Department of Veterans Affairs", "author": "TF Osborne", "journal-title": "Plos One", "key": "pone.0246825.ref007", "year": "2020" }, { "DOI": "10.21037/jgo.2018.08.13", "article-title": "The relationship between aspirin use and mortality in colorectal cancer", "author": "HJ Albandar", "doi-asserted-by": "crossref", "first-page": "1133", "issue": "6", "journal-title": "Journal of Gastrointestinal Oncology", "key": "pone.0246825.ref008", "volume": "9", "year": "2018" }, { "author": "JH Chow", "key": "pone.0246825.ref009", "volume-title": "Aspirin use is associated with decreased mechanical ventilation", "year": "2020" }, { "article-title": "Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study", "author": "D Wichmann", "journal-title": "Annals of internal medicine", "key": "pone.0246825.ref010", "year": "2020" }, { "article-title": "Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study", "author": "Y Li", "journal-title": "Stroke Vasc Neurol", "key": "pone.0246825.ref011", "year": "2020" }, { "DOI": "10.1016/j.mehy.2020.109975", "article-title": "Should aspirin be used for prophylaxis of COVID-19-induced coagulopathy?", "author": "AA Mohamed-Hussein", "doi-asserted-by": "crossref", "first-page": "109975", "journal-title": "Medical Hypotheses", "key": "pone.0246825.ref012", "volume": "144", "year": "2020" }, { "article-title": "Arterial Thrombosis in Coronavirus Disease 2019 Patients: A Rapid Systematic Review", "author": "I Cheruiyot", "first-page": "273", "journal-title": "Ann Vasc Surg. 2021 Jan", "key": "pone.0246825.ref013", "volume": "70" }, { "article-title": "Thrombosis and platelets: an update", "author": "M Koupenova", "first-page": "785", "issue": "11", "journal-title": "European heart journal", "key": "pone.0246825.ref014", "volume": "38", "year": "2017" }, { "DOI": "10.3389/fcvm.2020.562708", "article-title": "Aspirin Bioactivity for Prevention of Cardiovascular Injury in COVID-19", "author": "T Diaz", "doi-asserted-by": "crossref", "first-page": "317", "journal-title": "Frontiers in Cardiovascular Medicine", "key": "pone.0246825.ref015", "volume": "7", "year": "2020" }, { "DOI": "10.1111/irv.12421", "article-title": "Antiviral activity of aspirin against RNA viruses of the respiratory tract—an in vitro study", "author": "B Glatthaar‐Saalmüller", "doi-asserted-by": "crossref", "first-page": "85", "journal-title": "Influenza and other respiratory viruses", "key": "pone.0246825.ref016", "volume": "11", "year": "2017" }, { "DOI": "10.1136/bmj.m1185", "author": "P Little", "doi-asserted-by": "crossref", "key": "pone.0246825.ref017", "volume-title": "Non-steroidal anti-inflammatory drugs and covid-19", "year": "2020" }, { "key": "pone.0246825.ref018", "unstructured": "The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19: scientific brief, 19 April 2020: World Health Organization; 2020. Report No.: WHO/2019-nCoV/Sci_Brief/NSAIDs/2020.1. Accessed July 24, 2020" }, { "DOI": "10.1016/j.socscimed.2014.12.031", "article-title": "Income inequality and health: a causal review", "author": "KE Pickett", "doi-asserted-by": "crossref", "first-page": "316", "journal-title": "Social Science & Medicine", "key": "pone.0246825.ref019", "volume": "128", "year": "2015" }, { "DOI": "10.1016/j.socscimed.2020.113365", "article-title": "The trouble with trust: Time-series analysis of social capital, income inequality, and COVID-19 deaths in 84 countries", "author": "FJ Elgar", "doi-asserted-by": "crossref", "first-page": "113365", "journal-title": "Social Science & Medicine", "key": "pone.0246825.ref020", "volume": "263", "year": "2020" } ], "reference-count": 20, "references-count": 20, "relation": {}, "resource": { "primary": { "URL": "https://dx.plos.org/10.1371/journal.pone.0246825" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [ "Multidisciplinary" ], "subtitle": [], "title": "Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration", "type": "journal-article", "update-policy": "http://dx.doi.org/10.1371/journal.pone.corrections_policy", "volume": "16" }