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Effect of aspirin on short-term outcomes in hospitalized patients with COVID-19

Sahai et al., Vascular Medicine, doi:10.1177/1358863X211012754
May 2021  
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Mortality 13% Improvement Relative Risk Aspirin for COVID-19  Sahai et al.  LATE TREATMENT Is late treatment with aspirin beneficial for COVID-19? PSM retrospective 496 patients in the USA Lower mortality with aspirin (not stat. sig., p=0.53) c19early.org Sahai et al., Vascular Medicine, May 2021 Favorsaspirin Favorscontrol 0 0.5 1 1.5 2+
PSM retrospective 1,994 PCR+ patients in the USA, not showing a significant difference in mortality with aspirin treatment.
risk of death, 13.2% lower, RR 0.87, p = 0.53, treatment 33 of 248 (13.3%), control 38 of 248 (15.3%), NNT 50.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sahai et al., 19 May 2021, retrospective, propensity score matching, USA, peer-reviewed, 18 authors.
This PaperAspirinAll
Effect of aspirin on short-term outcomes in hospitalized patients with COVID-19
Aditya Sahai, Rohan Bhandari, Matthew Godwin, Thomas Mcintyre, Mina K Chung, Jean-Pierre Iskandar, Hayaan Kamran, Essa Hariri, Anu Aggarwal, Robert Burton, Ankur Kalra, John R Bartholomew, Keith R Mccrae, Ayman Elbadawi, James Bena, Lars G Svensson, Samir Kapadia, Scott J Cameron
Vascular Medicine, doi:10.1177/1358863x211012754
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is an ongoing viral pandemic marked by increased risk of thrombotic events. However, the role of platelets in the elevated observed thrombotic risk in COVID-19 and utility of antiplatelet agents in attenuating thrombosis is unknown. We aimed to determine if the antiplatelet effect of aspirin may mitigate risk of myocardial infarction, cerebrovascular accident, and venous thromboembolism in COVID-19. We evaluated 22,072 symptomatic patients tested for COVID-19. Propensity-matched analyses were performed to determine if treatment with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) affected thrombotic outcomes in COVID-19. Neither aspirin nor NSAIDs affected mortality in COVID-19. Thus, aspirin does not appear to prevent thrombosis and death in COVID-19. The mechanisms of thrombosis in COVID-19, therefore, appear distinct and the role of platelets as direct mediators of SARS-CoV-2-mediated thrombosis warrants further investigation.
Declaration of conflicting interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Supplementary material The supplementary material is available online with the article.
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Late treatment
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