Aspirin Is Related to Worse Clinical Outcomes of COVID-19

Abstract

Backgroundand Objectives: Aspirin is used globally to reduce pain and inflammation; however, its effect in patients with coronavirus disease (COVID-19) is not fully investigated and remains controversial. We evaluated the association between aspirin and COVID-19 outcomes using nationwide data from the Korean National Health Insurance System. Materials and Methods: This was a retrospective observational cohort study that included 22,660 eligible patients who underwent COVID-19 testing in South Korea between 1 January–31 July 2020. We identified all aspirin users prescribed aspirin within two weeks before or after the index date. The primary outcome was positivity for the COVID-19 test, and secondary outcomes included conventional oxygen therapy, intensive care unit, mechanical ventilation, or death. We applied the propensity score matching method to reduce the possible bias originating from the differences in patients’ baseline characteristics. Results: Of those eligible, 662 patients were prescribed aspirin. Among them, 136 patients were on aspirin within two weeks before diagnosis and 526 patients were on aspirin after diagnosis. The COVID-19 test positivity rate was not significantly different 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 the conventional oxygen therapy. Conclusion: Aspirin use was associated with adverse effects in COVID-19 patients. Further studies for mechanisms are needed.

Use of non-steroidal anti-inflammatory drugs and adverse outcomes during the COVID-19 pandemic: A systematic review and meta-analysis

“…After screening on titles, abstracts and full texts, forty comparative studies involving 4867,795 individuals were included in this review, in which eight are from the United States of America (USA), six are from South Korea, and four are from the United Kingdom (UK) ( Figure 1 ). 10 , 11 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 Twenty-eight (70%) of the included studies enrolled patients positive to SARS-CoV-2 tests. All forty studies included only adult cases.…”

D,L-Lysine-Acetylsalicylate + Glycine (LASAG) Reduces SARS-CoV-2 Replication and Shows an Additive Effect with Remdesivir

“…In particular, several studies on the administration of ASA in COVID-19 patients show a variable picture on the outcome [38,39,[48][49][50][51][52][53][54]. On the one hand, an improvement in mechanical ventilation and in-hospital deaths [38], and on the other hand, no effect of ASA on mortality [39,48,50,51,53,54] were reported.…”

Aspirin in COVID-19: Pros and Cons

“…Surprisingly, they found that a positive chest CT was correlated with antiplatelet intake despite adjustment (OR = 12.1 (1.41–167), p = 0.0354). While another retrospective cohort showed an increased risk of oxygen therapy in patients prescribed aspirin within 2 weeks after diagnosis ( Kim et al, 2021 ); but here propensity matching failed to adjust for a history of CAD. SARS-Cov-2 was indeed found to infect pulmonary endothelial cells causing endothelial injury and thrombosis ( Acosta and Singer, 2020 ).…”