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Summary of COVID-19 aspirin studies

Studies   Meta Analysis   Hide extended summaries

1,084 patient aspirin late treatment RCT: 16% lower mortality (p=0.05), 17% higher hospital discharge (p=0.08), and 21% lower progression (p=0.02).
RCT 1,557 critical patients, showing significantly lower mortality with aspirin, with 97.5% posterior probability of efficacy.

Mar 2022, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2790488, https://c19p.org/bradbury

412 patient aspirin late treatment study: 47% lower mortality (p=0.02), 44% lower ventilation (p=0.007), and 43% lower ICU admission (p=0.007).
Retrospective 412 hospitalized patients, 98 treated with aspirin, showing lower mortality, ventilation, and ICU admission with treatment.

Mar 2021, Anesthesia & Analgesia, https://journals.lww.com/anesthesia-analgesia/fulltext/2021/04000/aspirin_use_is_associated_with_decreased.2.aspx, https://c19p.org/chow

280 patient aspirin early treatment RCT: 67% lower hospitalization (p=0.49) and 19% lower progression (p=0.78).
Early terminated RCT with 164 aspirin and 164 control patients in the USA with very few events, showing no significant difference with aspirin treatment for the combined endpoint of all-cause mortality, symptomatic venous or arterial thromboembolism, myocardial infarction, stroke, and hospitalization for cardiovascular or pulmonary indication. There was no mortality and no major bleeding events among participants that started treatment (there was one ITT placebo death).

Oct 2021, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2785218, https://c19p.org/connors

98 patient aspirin late treatment RCT: 20% lower ventilation (p=1), 29% lower ICU admission (p=0.76), and 33% lower progression (p=0.74).
RCT 98 hospitalized patients in the USA, 49 treated with aspirin and dipyridamole, showing improved results with treatment, but without statistical significance.

Jan 2023, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274243, https://c19p.org/singla

2,664 patient aspirin prophylaxis PSM study: 67% lower combined mortality/intubation (p=0.0003).
PSM retrospective 2,664 COVID-19 hospitalized patients receiving steroids/antiviral therapy in Hong Kong, showing lower risk of combined death/intubation with aspirin use.

Jun 2023, Heart, https://heart.bmj.com/content/109/Suppl_3/A244.2, https://c19p.org/tse

232 patient aspirin late treatment PSM study: 75% lower mortality (p=0.03) and 2% slower viral clearance (p=0.94).
Retrospective PSM analysis of 232 hospitalized patients, 28 treated with aspirin, showing lower mortality with treatment. There was no significant difference in viral clearance.

Feb 2021, Medicine, https://journals.lww.com/md-journal/Fulltext/2021/02120/Effect_of_low_dose_aspirin_on_mortality_and_viral.41.aspx, https://c19p.org/liu2

661 patient aspirin late treatment RCT: 22% lower mortality (p=0.62), 9% lower ventilation (p=0.8), and 30% lower progression (p=0.46).
RCT hospitalized patients in India, 224 treated with atorvastatin, 225 with aspirin, and 225 with both, showing lower serum interleukin-6 levels with aspirin, but no statistically significant changes in other outcomes. Low dose aspirin 75mg daily for 10 days.

Jul 2022, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07570-5, https://c19p.org/ghati

10,477 patient aspirin prophylaxis study: 28% fewer cases (p=0.04) and 10% faster viral clearance (p=0.05).
Retrospective 10,477 patients in Israel, showing lower risk of COVID-19 cases with existing aspiring use.

Feb 2021, The FEBS J., https://febs.onlinelibrary.wiley.com/doi/10.1111/febs.15784, https://c19p.org/merzon2

2,070 patient aspirin late treatment study: 43% lower mortality (p=0.0006).
Retrospective 2,070 hospitalized patients in the USA, showing lower mortality with aspirin treatment.

Sep 2021, Anesthesiology, https://pubs.asahq.org/anesthesiology/article-abstract/doi/10.1097/ALN.0000000000003999/117698/Treatments-Associated-with-Lower-Mortality-among?redirectedFrom=fulltext, https://c19p.org/zhao5

13,628 patient aspirin prophylaxis PSM study: 59% lower mortality (p<0.0001).
Retrospective PSM analysis of pre-existing aspirin use in the USA, showing lower mortality with treatment.

Feb 2021, PloS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246825, https://c19p.org/osborne

638 patient aspirin late treatment PSM study: 48% lower mortality (p=0.004).
Retrospective 638 matched hospitalized patients in the USA, 319 treated with aspirin, showing lower mortality with treatment.

Jan 2021, American J. Hematology, https://onlinelibrary.wiley.com/doi/10.1002/ajh.26102, https://c19p.org/meizlish

21,579 patient aspirin prophylaxis study: 11% lower mortality (p=0.01), 22% lower ICU admission (p<0.0001), and 9% lower progression (p=0.02).
Retrospective 21,579 hospitalized COVID-19 patients mostly in the USA, showing lower risk of mortality and severity with existing aspirin use.

May 2022, Archivos de Bronconeumología, https://www.sciencedirect.com/science/article/pii/S0300289622005105, https://c19p.org/lal

65,149 patient aspirin prophylaxis study: 71% fewer cases (p=0.001).
Retrospective database analysis of 65,149 in South Korea, showing significantly lower cases with existing aspirin treatment. The journal version of this paper does not present the aspirin results (only combined results for NSAIDs).

May 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.05.04.20089904v2, https://c19p.org/huh3

7,824 patient aspirin late treatment PSM study: 38% lower mortality (p=0.02).
HOPE-COVID-19 PSM retrospective 7,824 patients, comparing prophylactic anticoagulation with and without additional treatment with aspirin in hospitalized patients, showing lower mortality with aspirin treatment.

Jun 2022, J. the American Heart Association, https://www.ahajournals.org/doi/10.1161/JAHA.121.024530, https://c19p.org/santoro3

351 patient aspirin late treatment PSM study: 27% lower mortality (p=0.03).
Retrospective 1,033 critical condition patients, showing lower in-hospital mortality with aspirin in PSM analysis. Patients receiving aspirin also had a higher risk of significant bleeding, although not reaching statistical significance. Authors note that the use of aspirin during an ICU stay should be tailored to each patient.

Sep 2021, J. Intensive Care Medicine, https://journals.sagepub.com/doi/pdf/10.1177/08850666221093229, https://c19p.org/alharthi

334,374 patient aspirin prophylaxis PSM study: 46% lower mortality (p=0.001).
PSM retrospective 334,374 COVID-19 patients showing decreased risk of venous thromboembolism, including pulmonary embolism and deep vein thrombosis, but increased risk of arterial thromboembolic disorders, including ischemic stroke and acute ischemic heart disease, with aspirin use prior to COVID-19 diagnosis. The increased risk of arterial disease may be associated with preexisting cardiovascular disease for which aspirin was already prescribed. All cause mortality was lower in the aspirin group, however authors do not discuss this result.

Apr 2024, medRxiv, https://www.medrxiv.org/content/10.1101/2024.04.10.24305647, https://c19p.org/ware

1,687 patient aspirin prophylaxis study: 33% lower mortality (p=0.03) and 20% lower hospitalization (p=0.13).
Retrospective 1,687 nursing home residents in the USA, showing significantly lower risk of mortality with chronic low-dose aspirin use. Low dose 81mg aspirin users had treatment ≥10 of 14 days prior to the positive COVID date, control patients had no aspirin use in the prior 14 days.

Aug 2022, medRxiv, https://www.medrxiv.org/content/10.1101/2022.08.03.22278392, https://c19p.org/abul

2,785 patient aspirin late treatment PSM study: 35% lower mortality (p=0.04), 49% higher ventilation (p=0.04), and 45% higher ICU admission (p=0.02).
PSM retrospective 2,785 hospitalized patients in the USA, showing lower mortality and higher ventilation and ICU admission with aspirin treatment.

Nov 2020, Blood, https://ashpublications.org/blood/article/136/Supplement%201/23/470342/Admission-Rothman-Index-Aspirin-and-Intermediate, https://c19p.org/goshua

14,892 patient aspirin late treatment RCT: 4% lower mortality (p=0.35), 5% lower ventilation (p=0.32), 6% higher hospital discharge (p=0.006), and 11% shorter hospitalization.
RCT 14,892 late stage patients, 7,351 treated with aspirin, showing slightly improved discharge and hospitalization time, and no significant difference for mortality. Results are limited due to low dose (150mg daily), very late treatment (9 days post symptom onset), and 96% concurrent use of low molecular weight heparin. Greater benefits were seen for non-LMWH patients, and for very late (<= 7 days from onset) vs. extremely late (>7 days) treatment. For more discussion see [twitter.com].

Nov 2021, RECOVERY Collaborative Group, The Lancet, https://www.sciencedirect.com/science/article/pii/S0140673621018250, https://c19p.org/recoverye

1,190 patient aspirin ICU study: 40% lower mortality (p<0.0001) and 37% lower ARDS (p=0.001).
Retrospective 1,190 ICU patients in Egypt, showing lower mortality with aspirin treatment. 150mg daily.

Oct 2022, Egyptian J. Anaesthesia, https://www.tandfonline.com/doi/full/10.1080/11101849.2022.2139104, https://c19p.org/ali6

1,124 patient aspirin ICU study: 31% lower mortality (p=0.003) and 10% lower ventilation (p=0.33).
Prospective study of 1,124 COVID-19 ICU patients, showing lower mortality with aspirin treatment.

Nov 2022, Research Square, https://www.researchsquare.com/article/rs-2313880/v1, https://c19p.org/aidouni

17,347 patient aspirin prophylaxis PSM study: 19% lower mortality (p=0.005) and 3% lower ventilation (p=0.21).
PSM retrospective 6,781 hospitalized patients ≥50 years old in the USA who were on pre-hospital antiplatelet therapy (84% aspirin), and 10,566 matched controls, showing lower mortality with treatment.

Aug 2021, J. Thrombosis and Haemostasis, https://onlinelibrary.wiley.com/doi/abs/10.1111/jth.15517, https://c19p.org/chow2

15,968 patient aspirin prophylaxis study: 18% lower mortality (p=0.0004).
Retrospective 15,968 COVID-19 hospitalized patients in Spain, showing lower mortality with existing use of several medications including metformin, HCQ, azithromycin, aspirin, vitamin D, vitamin C, and budesonide. Since only hospitalized patients are included, results do not reflect different probabilities of hospitalization across treatments.

Aug 2022, Virology J., https://virologyj.biomedcentral.com/articles/10.1186/s12985-023-02195-9, https://c19p.org/loucera3e

112,070 patient aspirin late treatment study: 13% lower mortality (p<0.0001).
Retrospective 112,269 hospitalized COVID-19 patients in the USA, showing lower mortality with aspirin treatment.

Mar 2022, JAMA Network Open, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790439, https://c19p.org/chow3

310 patient aspirin prophylaxis study: 14% lower mortality (p=0.72), 28% lower ICU admission (p=0.17), 25% lower ARDS (p=0.39), and 2% lower hospitalization (p=0.94).
Retrospective 539 patients in the USA, showing lower mortality, ICU admission, and ARDS with aspirin treatment, without statistical significance.

Jul 2022, Health Science Reports, https://onlinelibrary.wiley.com/doi/10.1002/hsr2.699, https://c19p.org/malik

32 patient aspirin ICU study: 46% lower mortality (p=0.63).
Retrospective 32 ICU patients showing lower mortality with aspirin treatment, without statistical significance.

Aug 2021, Microbial Drug Resistance, https://www.liebertpub.com/doi/full-xml/10.1089/mdr.2020.0489, https://c19p.org/karruli

58 patient aspirin prophylaxis study: 58% lower mortality (p=0.43).
Retrospective 58 multiple myeloma COVID-19 patients in the USA, showing no significant difference with aspirin treatment.

Jul 2020, J. Hematology & Oncology, https://jhoonline.biomedcentral.com/articles/10.1186/s13045-020-00934-x, https://c19p.org/wang3e

991 patient aspirin late treatment study: 25% lower mortality (p=0.04).
Retrospective 991 hospitalized patients in Iran, showing lower mortality with aspirin treatment.

Apr 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/10.1002/jmv.27053, https://c19p.org/hajiaghajanie

aspirin prophylaxis study: 1% lower mortality (p=0.95) and 12% fewer cases (p=0.04).
Retrospective database analysis of 328,374 adults in South Korea, showing lower risk of COVID-19 cases with aspirin use, but no difference in mortality for COVID-19 patients.

Jun 2021, Yonsei Medical J., https://eymj.org/DOIx.php?id=10.3349/ymj.2021.62.7.577, https://c19p.org/oh2

1,645 patient aspirin prophylaxis study: 28% lower mortality (p=0.07).
Retrospective 1,645 hospitalized patients in the USA, showing lower mortality with aspirin use, without statistical significance.

Nov 2022, Chest, https://www.sciencedirect.com/science/article/pii/S0012369222041617, https://c19p.org/ali7

849 patient aspirin prophylaxis study: 26% lower combined mortality/hospitalization (p=0.13).
Retrospective 849 COVID-19+ patients in skilled nursing homes, showing lower risk of combined hospitalization/death with aspirin prophylaxis, not reaching statistical significance.

Jan 2022, Gerontology, https://www.karger.com/Article/FullText/521412, https://c19p.org/levye

917,198 patient aspirin late treatment study: 16% lower mortality (p<0.0001).
Retrospective study of 917,198 hospitalized COVID-19 cases covered by the Iran Health Insurance Organization over 26 months showing that antithrombotics, corticosteroids, and antivirals reduced mortality while diuretics, antibiotics, and antidiabetics increased it. Confounding makes some results very unreliable. For example, diuretics like furosemide are often used to treat fluid overload, which is more likely in ICU or advanced disease requiring aggressive fluid resuscitation. Hospitalization length has increased risk of significant confounding, for example longer hospitalization increases the chance of receiving a medication, and death may result in shorter hospitalization. Mortality results may be more reliable. Confounding by indication is likely to be significant for many medications. Authors adjustments have very limited severity information (admission type refers to ward vs. ER department on initial arrival). We can estimate the impact of confounding from typical usage..

Dec 2023, Frontiers in Public Health, https://www.frontiersin.org/articles/10.3389/fpubh.2023.1280434/full, https://c19p.org/mehrizie

20,730 patient aspirin prophylaxis study: 3% lower mortality (p=0.06).
Retrospective 28,856 COVID-19 patients in the USA, showing no significant difference in mortality for chronic aspirin use vs. sporadic NSAID use. Since aspirin is available OTC and authors only tracked prescriptions, many patients classified as sporadic users may have been chronic users.

May 2022, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267462, https://c19p.org/campbell2

aspirin prophylaxis study: 37% lower mortality (p=0.28) and 1% higher ICU admission (p=0.79).
Retrospective 4,017 coronary artery disease patients hospitalized for COVID-19 in the USA, showing no significant difference in outcomes with low dose aspirin use.

Dec 2022, Innovation in Aging, https://academic.oup.com/innovateage/article/6/Supplement_1/850/6939246, https://c19p.org/zadeh

496 patient aspirin late treatment PSM study: 13% lower mortality (p=0.53).
PSM retrospective 1,994 PCR+ patients in the USA, not showing a significant difference in mortality with aspirin treatment.

May 2021, Vascular Medicine, https://journals.sagepub.com/doi/10.1177/1358863X211012754, https://c19p.org/sahai

1,054 patient aspirin late treatment PSM study: 15% lower mortality (p=0.08).
PSM retrospective TriNetX database analysis of 1,379 severe COVID-19 patients requiring respiratory support, showing lower mortality with aspirin (not reaching statistical significance) and famotidine, and improved results from the combination of both.

Mar 2021, Signal Transduction and Targeted Therapy, https://www.nature.com/articles/s41392-021-00689-y, https://c19p.org/mura

984 patient aspirin prophylaxis study: 7% higher mortality (p=0.65) and 30% lower combined mortality/intubation (p=0.01).
Retrospective 984 COVID-19 patients, 253 taking aspirin prior to admission, showing lower risk of respiratory support upgrade with treatment.

Oct 2021, Int. J. Cardiology, https://www.sciencedirect.com/science/article/abs/pii/S0167527321014996, https://c19p.org/sisinni

aspirin prophylaxis study: 22% lower progression (p=0.3) and 3% more cases (p=0.8).
Retrospective 2,736,091 individuals in the U.S., U.K., and Sweden, showing lower risk of hospital/clinic visits with aspirin use.

May 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.04.28.21256261, https://c19p.org/drew

11,475 patient aspirin prophylaxis PSM study: 24% lower mortality (p=0.52), 7% higher progression (p=0.8), and 11% more cases (p=0.21).
PSM retrospective case control study in South Korea, showing a trend towards lower mortality, but no significant differences with aspirin use.

Jul 2021, Medicine, https://journals.lww.com/10.1097/MD.0000000000026670, https://c19p.org/son

125 patient aspirin prophylaxis study: 6% higher mortality (p=0.87), 50% lower ventilation (p=0.16), and 49% lower ICU admission (p=0.41).
Retrospective 125 COVID+ hospitalized patients in the USA, showing no significant differences with aspirin prophylaxis.

Mar 2022, World J. Critical Care Medicine, https://www.wjgnet.com/2220-3141/full/v11/i2/92.htm, https://c19p.org/gogtay

183 patient aspirin late treatment study: 96% lower mortality (p=0.22).
Retrospective 183 hospitalized pediatric COVID-19 patients in Iran, showing no significant difference in mortality with in unadjusted results.

Jul 2023, Canadian J. Infectious Diseases and Medical Microbiology, https://www.hindawi.com/journals/cjidmm/2023/5205188/, https://c19p.org/shamsie

444 patient aspirin late treatment study: 44% lower mortality (p=0.28).
Retrospective 444 hospitalized patients in Pakistan, showing lower mortality with aspirin treatment in unadjusted results, not reaching statistical significance.

Dec 2021, Exploratory Research in Clinical and Social Pharmacy, https://www.sciencedirect.com/science/article/pii/S2667276621001013, https://c19p.org/mustafae

587 patient aspirin late treatment study: 22% lower mortality (p=0.56) and 10% higher ICU admission (p=0.67).
Retrospective 587 COVID+ hospitalized patients in Iran, showing no significant differences in outcomes with aspirin treatment.

Jul 2021, Identification of Biomarkers, New Treatments, and Vaccines for COVID-19, https://link.springer.com/chapter/10.1007%2F978-3-030-71697-4_17, https://c19p.org/vahedianazimi2

9,229 patient aspirin prophylaxis study: 1% lower ventilation (p=0.97).
Retrospective 9,748 COVID-19 patients in the USA showing no signficant difference with aspirin use.

Feb 2021, Clinical Pharmacology & Therapeutics, https://onlinelibrary.wiley.com/doi/10.1002/cpt.2376, https://c19p.org/bejane

183 patient aspirin prophylaxis study: 4% lower mortality (p=0.89).
Retrospective 183 hospitalized patients in China, 52 taking low-dose aspirin prior to hospitalization, showing no significant difference with treatment.

Dec 2020, J. Cellular and Molecular Medicine, https://onlinelibrary.wiley.com/doi/10.1111/jcmm.16198, https://c19p.org/yuan

465 patient aspirin ICU study: 10% lower mortality (p=0.5).
Prospective study of 465 COVID-19 ICU patients in Libya showing no significant differences with treatment.

Apr 2021, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251085, https://c19p.org/elhadie

3,881 patient aspirin late treatment RCT: 9% higher mortality (p=0.84), 20% lower progression (p=0.21), and 17% lower hospitalization (p=0.31).
Late (5.4 days) outpatient RCT showing no significant difference in outcomes with aspirin treatment.

Oct 2022, The Lancet Respiratory Medicine, https://www.sciencedirect.com/science/article/pii/S2213260022002995, https://c19p.org/eikelboom2e

77,221 patient aspirin prophylaxis PSM study: 9% lower mortality (p=0.12), 2% lower hospitalization (p=0.47), 9% more symptomatic cases (p=0.18), and 7% more cases (p=0.09).
UK Biobank retrospective 77,271 patients aged 50-86, showing no significant differences with aspirin use. Matching lead to different results for the gender vs. overall analysis, for example the overall result for cases was OR 1.07, however both gender results are lower OR 0.97 and 1.02.

Aug 2021, Drugs & Aging, https://link.springer.com/article/10.1007%2Fs40266-021-00886-y, https://c19p.org/ma3

262 patient aspirin prophylaxis study: no change in mortality (p=1).
Retrospective 131 COVID-19 patients with aspirin use and 131 matched controls in Iran, showing no significant difference in outcomes, however age matching used only two categories, 40-60 and 60+, therefore matching may be very poor given the relationship between age and COVID-19 risk. The percentages given for the control group death/recovery outcomes do not match the reported counts.

Feb 2023, J. Nephropharmacology, https://www.jnephropharmacology.com/Inpress/npj-10506.pdf, https://c19p.org/azizi

2,148 patient aspirin prophylaxis study: 4% lower hospitalization (p=0.08) and 18% higher severe cases (p=0.28).
Retrospective 2,148 COVID-19 recovered patients in Jordan, showing no significant differences in the risk of severity and hospitalization with aspirin prophylaxis.

Feb 2022, Bosnian J. Basic Medical Sciences, https://www.bjbms.org/ojs/index.php/bjbms/article/view/7009, https://c19p.org/nimere

459 patient aspirin late treatment study: 28% higher mortality (p=0.52).
Retrospective 459 patients in Iran, 53 treated with aspirin, showing no significant difference with treatment.

Sep 2020, Tohoku J. Exp. Med., 2020, 252, 73-84, https://www.jstage.jst.go.jp/article/tjem/252/1/252_73/_article/-char/ja/, https://c19p.org/alamdarie

aspirin prophylaxis study: 13% higher mortality (p=0.38), 3% lower hospitalization (p=0.64), no change in progression (p=0.98), and 8% fewer cases (p=0.02).
Population-based case-control study of 86,602 people in Spain, shower lower risk of COVID-19 cases with low-dose aspirin, but no significant difference for severity, hospitalization, or mortality.

Jan 2024, Revista Española de Cardiología, https://www.sciencedirect.com/science/article/pii/S1885585724000148, https://c19p.org/prietocampo

2,468 patient aspirin late treatment study: 32% higher mortality (p=0.04).
Prospective study of 2,468 hospitalized COVID-19 patients in Iran, showing higher mortality with aspirin treatment. IR.MUQ.REC.1399.013.

May 2021, Research Square, https://www.researchsquare.com/article/rs-365321/v2, https://c19p.org/pourhoseingholie

149 patient aspirin ICU study: 10% higher mortality (p=0.43).
Retrospective 149 patients under invasive mechanical ventilation in Germany showing no significant difference in mortality with aspirin prophylaxis in unadjusted results.

Mar 2023, Scientific Reports, https://www.nature.com/articles/s41598-023-31944-7, https://c19p.org/aweimere

67 patient aspirin late treatment study: 8% higher ventilation (p=0.93).
Retrospective 225 hospitalized patients in Egypt, showing significantly lower thromboembolic events with aspirin treatment, but no significant difference in the need for mechanical ventilation.

Jul 2021, Clinical Drug Investigation, https://link.springer.com/article/10.1007/s40261-021-01061-2, https://c19p.org/abdelwahab

3,219 patient aspirin prophylaxis study: 14% higher mortality (p=0.21).
Retrospective database analysis of 3,219 hospitalized patients in the USA. Very different results in the time period analysis (Table S2), and results significantly different to other studies for the same medications (e.g., heparin OR 3.06 [2.44-3.83]) suggest significant confounding by indication and confounding by time.

Apr 2021, BMJ Open, https://bmjopen.bmj.com/content/11/4/e042042.info, https://c19p.org/mulheme

689 patient aspirin prophylaxis study: 34% higher combined mortality/ICU admission (p=0.09).
Retrospective 689 hospitalized COVID-19 patients in Denmark, showing higher risk of ICU/death with aspirin use in unadjusted results subject to confounding by indication.

May 2020, J. Hypertension, https://journals.lww.com/10.1097/HJH.0000000000002515, https://c19p.org/holt2e

13,585 patient aspirin prophylaxis PSM study: 8% lower mortality (p=0.52), 1% higher ventilation (p=0.96), 12% higher ICU admission (p=0.36), and 18% higher hospitalization (p=0.04).
Retrospective 13,585 COVID+ patients in the USA, showing higher hospitalization with aspirin use, and no significant difference for mortality, ventilation, and ICU admission.

Oct 2022, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0275787, https://c19p.org/morrisone

478 patient aspirin late treatment study: 123% higher mortality (p=0.008).
Retrospective 478 moderate to severe hospitalized patients in Iran, showing higher mortality with aspirin treatment. Authors note confounding by indication for aspirin treatment.

Oct 2022, J. Pharmaceutical Care, https://publish.kne-publishing.com/index.php/JPC/article/view/10790, https://c19p.org/karimpourrazkenari2e

790 patient aspirin prophylaxis study: 29% higher mortality (p=0.02).
Retrospective 790 hospitalized type 2 diabetes patients ≥80 years old in Spain, showing higher mortality with existing aspirin use.

Dec 2020, Research Square, https://www.researchsquare.com/article/rs-133358/v1, https://c19p.org/ramosrincone

aspirin prophylaxis PSM study: 31% higher mortality (p=0.04).
PSM retrospective 3,712 hospitalized patients in Spain, showing lower mortality with existing use of azithromycin, bemiparine, budesonide-formoterol fumarate, cefuroxime, colchicine, enoxaparin, ipratropium bromide, loratadine, mepyramine theophylline acetate, oral rehydration salts, and salbutamol sulphate, and higher mortality with acetylsalicylic acid, digoxin, folic acid, mirtazapine, linagliptin, enalapril, atorvastatin, and allopurinol.

Jan 2022, Pharmaceuticals, https://www.mdpi.com/1424-8247/15/1/78, https://c19p.org/monserratvillatoroe

763 patient aspirin prophylaxis study: 49% higher mortality (p=0.0001).
Retrospective 770 COVID-19 patients with cancer, showing increased mortality with aspirin use in unadjusted results.

Oct 2021, Medicina Clínica, https://www.sciencedirect.com/science/article/pii/S238702062100485X, https://c19p.org/perezsegura

390 patient aspirin prophylaxis study: 13% higher mortality (p=0.0003).
Retrospective 390 hospitalized patients in Israel, showing higher risk of mortality with prior aspirin use. Details of the analysis are not provided.

Oct 2021, Metabolites, https://www.mdpi.com/2218-1989/11/10/679, https://c19p.org/basheer

2,119 patient aspirin late treatment RCT: 5% higher mortality (p=0.66) and 8% lower progression (p=0.32).
RCT very late stage (baseline SpO2 77%) patients, showing no significant differences with rivaroxaban and aspirin treatment.

Oct 2022, The Lancet Respiratory Medicine, https://www.sciencedirect.com/science/article/pii/S2213260022002983, https://c19p.org/eikelboome

31,072,642 patient aspirin prophylaxis study: 4% higher combined mortality/intubation (p=0.18) and 3% higher hospitalization (p=0.05).
Retrospective 31 million people without cardiovascular disease in France, showing no significant difference in hospitalization or combined intubation/death with low dose aspirin prophylaxis.

Jun 2022, Research and Practice in Thrombosis and Haemostasis, https://onlinelibrary.wiley.com/doi/10.1002/rth2.12743, https://c19p.org/botton

762 patient aspirin prophylaxis study: 13% higher mortality (p=0.63) and 2% higher combined mortality/intubation (p=0.93).
Retrospective 762 COVID+ hospitalized patients in the USA, 239 on antiplatelet medication (199 aspirin), showing no significant differences in outcomes. For more discussion see [sciencedirect.com].

May 2021, Heart & Lung, https://www.heartandlung.org/article/S0147-9563(21)00175-8/fulltext, https://c19p.org/pan

20,641 patient aspirin prophylaxis PSM study: 3% higher mortality (p=0.48), 3% higher ventilation (p=0.75), and 4% higher ICU admission (p=0.65).
Retrospective 20,641 hospitalized patients in Spain, showing no significant difference in outcomes with existing aspirin use.

Nov 2021, Internal and Emergency Medicine, https://link.springer.com/10.1007/s11739-021-02870-1, https://c19p.org/formiga2

430 patient aspirin late treatment study: 70% higher mortality (p=0.02).
Retrospective 430 hospitalized COVID-19 patients with type 2 diabetes in Poland showing lower mortality with metformin and higher mortality with remdesivir, convalescent plasma, and aspirin in univariable analysis. These results were not statistically significant except for aspirin, and no baseline information per treatment is provided to assess confounding.

Mar 2024, Biomedicines, https://www.mdpi.com/2227-9059/12/3/605, https://c19p.org/lewandowski2e

1,047 patient aspirin prophylaxis study: 10% higher mortality (p=0.52), 110% higher ICU admission (p=0.007), and 10% longer hospitalization (p=0.02).
Retrospective 1,047 pneumonia patients in 5 COVID-19 geriatric units in France and Switzerland, significantly higher ICU admission and longer hospital stays with existing aspirin treatment. Numbers in this study appear to be inconsistent, for example the abstract says 147 of 301 aspirin patients died, shown as 34.3%, while Table 1 shows 104 of 301 (34.6%).

Jan 2022, GeroScience, https://link.springer.com/article/10.1007%2Fs11357-021-00499-8, https://c19p.org/sullerot

9,842 patient aspirin prophylaxis PSM study: 61% higher mortality (p<0.0001) and 309% higher severe cases (p<0.0001).
N3C retrospective 250,533 patients showing significantly higher mortality with aspirin use. Note that aspirin results were not included in the journal version or v2 of this preprint.

Apr 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.04.13.21255438v1, https://c19p.org/reesee

272 patient aspirin prophylaxis PSM study: 700% higher mortality (p=0.03), 433% higher ventilation (p=0.14), 433% higher ICU admission (p=0.14), and 33% fewer cases (p=0.29).
Retrospective database analysis of 22,660 patients tested for COVID-19 in South Korea. There was no significant difference in cases according to aspirin use. Aspirin use before COVID-19 was related to an increased death rate and aspirin use after COVID-19 was related to a higher risk of oxygen therapy.

Sep 2021, Medicina, https://www.mdpi.com/1648-9144/57/9/931, https://c19p.org/kim2
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