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

Abstract

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.

Active prescription of low-dose aspirin during or prior to hospitalization and mortality in COVID-19: A systematic review and meta-analysis of adjusted effect estimates

“…(Lima-Morales et al, 2021) There were 6 eligible studies that were included in this meta-analysis, comprising of 13,993 patients [Figure 1]. (Jonathan H. Chow et al, 2021;Liu et al, 2021;Meizlish et al, 2021;Merzon et al, 2021;Osborne et al, 2021;Yuan et al,…”

Low-dose aspirin for early COVID-19: does the early bird catch the worm?

“…In the absence of randomized controlled clinical trials, the best evidence for early use of aspirin comes from a recently reported large retrospective study by Osborne et al [26] analyzing outcomes in American veterans with COVID-19. In this study, 6,300 COVID-19 positive American Veterans with preexisting aspirin prescription were compared with 6,300 COVID-19 positive patients matched via propensity scores but not taking aspirin.…”

A Randomized Open-Label Trial To Evaluate The Efficacy And Safety Of Triple Therapy With Aspirin, Atorvastatin, And Nicorandil In Hospitalised Patients With SARS Cov-2 Infection: A Structured Summary Of A Study Protocol For A Randomized Controlled Trial

“…COVID-19 positive Veterans Health Administration patients with active aspirin prescriptions have a signi cantly decreased risk of mortality as indicated by unadjusted odds ratios of 0.68 (95% CI of0.57-0.80) at 14 days, and 0.68 (95% CI of 0.59-0.77) at 30 days after diagnosis (12).…”