The use of aspirin for primary prevention of cardiovascular disease is associated with a lower likelihood of COVID‐19 infection

Abstract

Acetylsalicylic acid (aspirin) is commonly used for primary and secondary prevention of cardiovascular diseases. Aspirin use is associated with better outcomes among COVID‐19 positive patients. We hypothesized that aspirin use for primary cardiovascular disease prevention might have a protective effect on COVID‐19 susceptibility and disease duration. We conducted a retrospective population‐based cross‐sectional study, utilizing data from the Leumit Health Services database. The proportion of patients treated with aspirin was significantly lower among the COVID‐19‐positive group, as compared to the COVID‐19‐negative group (73 (11.03 %) vs. 1548 (15.77%); p=0.001). Aspirin use was associated with lower likelihood of COVID‐19 infection, as compared to non‐users (adjusted OR 0.71 (95% CI, 0.52 to 0.99; p=0.041). Aspirin users were older (68.06 ± 12.79 vs. 56.63 ± 12.28 years of age; p<0.001), presented a lower BMI (28.77±5.4 vs. 30.37±4.55; p<0.0189) and showed higher prevalence of hypertension (56, 76.71%), diabetes (47, 64.38%) and COPD (11, 15.07%) than showed the aspirin non‐users (151, 25.64%, p<0.001; 130, 22.07%, p<0.001; and 43, 7.3%, p=0.023, respectively). Moreover, COVID‐19 disease duration (considered as the time between the first positive and second negative COVID‐19 RT‐PCR test results) among aspirin users was significantly shorter, as compared to aspirin non‐users (19.8±7.8 vs. 21.9± 7.9 p= 0.045). Among hospitalized COVID‐positive patients, a higher proportion of surviving subjects were treated with aspirin (20, 19.05%), as opposed to 1 dead subject (14.29%), although this difference was not significant (p=0.449). In conclusion, we observed inverse association between the likelihood of COVID‐19 infection, disease duration and mortality and aspirin use for primary prevention.

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,…”

Use of aspirin in reduction of mortality of COVID‐19 patients: A meta‐analysis

“…Finally, 10 articles were included in a quantitative synthesis that involved 56 696 COVID‐19 patients from 10 observational studies. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 The one article among these 10 articles was preprint. 24 …”

“…The data were extracted from 10 studies. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 The extracted data were included in an excel sheet that contains the columns like authors' first names, year of study, type of study, sex, the total number of subjects (non‐aspirin), the number of subjects survived (non‐aspirin), the total number of subjects (aspirin), and the number of subjects survived (aspirin) as mentioned in Table 1 .…”

Don't forget arterial thrombosis in patients with COVID-19: A case series

“…Several studies have noted that treatment with aspirin before diagnosis with COVID-19 may correlate with favorable outcomes; milder disease, less ICU admission and reduced mortality rates [ [17] , [18] , [19] ]. Mortality was also lower among COVID-19 patients who received aspirin during hospitalization [ 20 ].…”