Low-dose Aspirin Reduces Risk of COVID-19 Mortality in Hospitalized Patients

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Risk of complications and death among hospitalized COVID-19 patients who were taking prophylactic daily low-dose aspirin were significantly lower compared to patients who were not taking aspirin, according to findings of a study published today in the journal Anesthesia and Analgesia.

According to study authors from the University of Maryland School of Medicine (UMSOM), patients taking aspirin also were less likely to be admitted to an intensive care unit (ICU) or to be placed on mechanical ventilation.

“If our finding is confirmed, it would make aspirin the first widely available, over-the-counter medication to reduce mortality in COVID-19 patients,” said study leader Jonathan Chow, MD, assistant professor of anesthesiology at UMSOM, in a university statement.

The retrospective observational cohort study tracked data from more than 400 patients (mean age 55 years) admitted with COVID-19 to one of 4 US hospitals between March 2020 and July 2020. Nearly 24% of patients received low-dose (81 mg) aspirin within 24 hours of hospital admission or 7 days prior to admission.

Researchers observed a 47% reduction in overall risk of in-hospital mortality in patients taking daily low-dose aspirin, a 44% reduction in risk of being placed on mechanical ventilation, and a 43% reduction in risk of ICU admission.

Adjustment for confounding variables included presence of age, gender, BMI, race, hypertension, diabetes mellitus, coronary artery disease, renal disease, liver disease, and home beta blocker use.

In the study’s Discussion the authors suggest that aspirin may mitigate the well-described hypercoagulable and prothrombotic state associated with CVOID-19 and also point to an earlier study that showed systemic anticoagulation with heparin can reduce mortality in mechanically ventilated patients.

But, until a large, randomized controlled trial can be conducted to confirm the study’s findings and asses the extent to which a causal relationship can be attribute to the one observed here, the authors say it is “imperative to exercise cautious optimism” and to always balance the known risks of aspirin against what could be a potential benefit in COVID-19 patients.
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For an interview with lead investigator Jonathan Chow, MD, see: Aspirin Reduces COVID-19 Mortality: Investigator's Insights ​