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Other Treatments Global Adoption
Aspirin COVID-19 studies. Benefit may be more likely without coadministered anticoagulants. Recent:
Aspirin has been officially adopted for early treatment in part of 1 country. Submit updates/corrections.
Aug 5
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
Aspirin for COVID-19: real-time meta analysis of 50 studies
Details   • Statistically significant improvement is seen for mortality. 22 studies from 20 independent teams in 8 different countries show statistically significant improvements in isolation (17 for the most serious outcome). • Meta analysis using..
Aug 4
PrEPPEP Abul et al., medRxiv, doi:10.1101/2022.08.03.22278392 (Preprint)
death, ↓33.0%, p=0.03
Association of mortality and aspirin use for COVID-19 residents at VA Community Living Center Nursing Homes
Details   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 pat..
Jul 11
PrEPPEP Malik et al., Health Science Reports, doi:10.1002/hsr2.699
death, ↓13.6%, p=0.72
Effect of low dose acetylsalicylic acid and anticoagulant on clinical outcomes in COVID‐19, analytical cross‐sectional study
Details   Retrospective 539 patients in the USA, showing lower mortality, ICU admission, and ARDS with aspirin treatment, without statistical significance.
Jul 9
Late Ghati et al., BMC Infectious Diseases, doi:10.1186/s12879-022-07570-5
death, ↓22.1%, p=0.62
Statin and aspirin as adjuvant therapy in hospitalised patients with SARS-CoV-2 infection: a randomised clinical trial (RESIST trial)
Details   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 75..
Jun 22
Late Santoro et al., Journal of the American Heart Association, doi:10.1161/JAHA.121.024530
death, ↓38.0%, p=0.02
Aspirin Therapy on Prophylactic Anticoagulation for Patients Hospitalized With COVID‐19: A Propensity Score‐Matched Cohort Analysis of the HOPE‐COVID‐19 Registry
Details   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 17
PrEPPEP Botton et al., Research and Practice in Thrombosis and Haemostasis, doi:10.1002/rth2.12743
death/int., ↑4.0%, p=0.18
No association of low-dose aspirin with severe COVID-19 in France: A cohort of 31.1 million people without cardiovascular disease
Details   Retrospective 31 million people without cardiovascular disease in France, showing no significant difference in hospitalization or combined intubation/death with low dose aspirin prophylaxis.
May 30
Early Kumar et al., Cureus, doi:10.7759/cureus.25467
no recov., ↓89.2%, p=0.05
Efficacy and Safety of Aspirin, Promethazine, and Micronutrients for Rapid Clinical Recovery in Mild to Moderate COVID-19 Patients: A Randomized Controlled Clinical Trial
Details   RCT 260 patients in India, 130 treated with aspirin, promethazine, vitamin C, D, B3, zinc, and selenium, showing faster recovery with treatment. There was no hospitalization, ICU admission, or supplemental oxygen requirements in either gr..
May 5
PrEPPEP Lal et al., AJRCCM Conference (Preprint)
death, ↓11.0%, p=0.01
Pre-Hospital Aspirin Use and Patient Outcomes in Covid-19: Results from the International Viral Infection and Respiratory Illness Universal Study (Virus)
Details   Retrospective 21,579 hospitalized COVID-19 patients mostly in the USA, showing lower risk of mortality and severity with existing aspirin use.
May 5
PrEPPEP Campbell et al., PLOS ONE, doi:10.1371/journal.pone.0267462
death, ↓3.0%, p=0.06
Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen and relationship with mortality among United States Veterans after testing positive for COVID-19
Details   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 classif..
Mar 24
Late Chow et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2022.3890
death, ↓13.5%, p<0.0001
Association of Early Aspirin Use With In-Hospital Mortality in Patients With Moderate COVID-19
Details   Retrospective 112,269 hospitalized COVID-19 patients in the USA, showing lower mortality with aspirin treatment.
Mar 22
Late Bradbury et al., JAMA, doi:10.1001/jama.2022.2910
death, ↓16.0%, p=0.05
Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19: A Randomized Clinical Trial
Details   RCT 1,557 critical patients, showing significantly lower mortality with aspirin, with 97.5% posterior probability of efficacy. REMAP-CAP. NCT02735707.
Mar 9
PrEPPEP Gogtay et al., World Journal of Critical Care Medicine, doi:10.5492/wjccm.v11.i2.92
death, ↑5.9%, p=0.87
Retrospective analysis of aspirin's role in the severity of COVID-19 pneumonia
Details   Retrospective 125 COVID+ hospitalized patients in the USA, showing no significant differences with aspirin prophylaxis.
Feb 28
PrEPPEP Nimer et al., Bosnian Journal of Basic Medical Sciences, doi:10.17305/bjbms.2021.7009
hosp., ↓3.7%, p=0.08
The impact of vitamin and mineral supplements usage prior to COVID-19 infection on disease severity and hospitalization
Details   Retrospective survey based analysis of 2,148 COVID-19 recovered patients in Jordan, showing no significant differences in the risk of severity and hospitalization with aspirin prophylaxis.
Jan 31
PrEPPEP Levy et al., Gerontology, doi:10.1159/000521412
death/hosp., ↓26.0%, p=0.13
Frail Older Adults with Presymptomatic SARS-CoV-2 Infection: Clinical Course and Prognosis
Details   Retrospective 849 COVID-19+ patients in skilled nursing homes, showing lower risk of combined hospitalization/death with aspirin prophylaxis, not reaching statistical significance.
Jan 24
Early de Jesús Ascencio-Montiel et al., Archives of Medical Research, doi:10.1016/j.arcmed.2022.01.002
death/hosp., ↓59.0%, p<0.0001
A Multimodal Strategy to Reduce the Risk of Hospitalization/death in Ambulatory Patients with COVID-19
Details   Retrospective 28,048 COVID+ patients in Mexico, 7,898 receiving a treatment kit including low dose ivermectin, AZ, aspirin, and acetaminophen, shower lower mortality/hospitalization for those receiving the kit. Delivery of the treatment k..
Jan 8
PrEPPEP Monserrat Villatoro et al., Pharmaceuticals, doi:10.3390/ph15010078
death, ↑31.0%, p=0.04
A Case-Control of Patients with COVID-19 to Explore the Association of Previous Hospitalisation Use of Medication on the Mortality of COVID-19 Disease: A Propensity Score Matching Analysis
Details   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..
Jan 7
PrEPPEP Sullerot et al., GeroScience, doi:10.1007/s11357-021-00499-8
death, ↑10.0%, p=0.52
Premorbid aspirin use is not associated with lower mortality in older inpatients with SARS-CoV-2 pneumonia
Details   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,..
Dec 29
Late Mustafa et al., Exploratory Research in Clinical and Social Pharmacy, doi:10.1016/j.rcsop.2021.100101
death, ↓44.1%, p=0.28
Pattern of medication utilization in hospitalized patients with COVID-19 in three District Headquarters Hospitals in the Punjab province of Pakistan
Details   Retrospective 444 hospitalized patients in Pakistan, showing lower mortality with aspirin treatment in unadjusted results, not reaching statistical significance.
Dec 24
Meta Banaser et al., International Journal of Medicine in Developing Countries, doi:10.24911/IJMDC.51-1640383699 (meta analysis)
death, ↓49.0%, p<0.0001
A systematic review and meta-analysis on efficacy of low dose aspirin on the management of COVID-19
Details   Meta analysis of 8 studies showing significantly lower mortality and mechanical ventilation with low dose aspirin.
Nov 18
Late RECOVERY Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)01825-0
death, ↓4.0%, p=0.35
Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Details   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 ..
Oct 14
Late Santoro et al., European Heart Journal, doi:10.1093/eurheartj/ehab724.3002
death, ↓71.0%, p<0.0001
Antiplatelet therapy and outcome in patients with COVID-19. Results from a multi-center international prospective registry (HOPE-COVID19)
Details   Retrospective database analysis of 7,824 patients in the HOPE-COVID19 registry, 730 receiving antiplatelet therapy including aspirin, showing lower mortality with treatment. Authors do not provide results restricted to aspirin.
Oct 11
Early Connors et al., JAMA, doi:10.1001/jama.2021.1727283
hosp., ↓67.3%, p=0.49
Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19
Details   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 thro..
Oct 4
PrEPPEP Pérez-Segura et al., Medicina Clínica, doi:10.1016/j.medcle.2021.02.010
death, ↑49.1%, p=0.0001
Prognostic factors at admission on patients with cancer and COVID-19: Analysis of HOPE registry data
Details   Retrospective 770 COVID-19 patients with cancer, showing increased mortality with aspirin use in unadjusted results.
Oct 4
PrEPPEP Sisinni et al., International Journal of Cardiology, doi:10.1016/j.ijcard.2021.09.058
death, ↑7.1%, p=0.65
Pre-admission acetylsalicylic acid therapy and impact on in-hospital outcome in COVID-19 patients: The ASA-CARE study
Details   Retrospective 984 COVID-19 patients, 253 taking aspirin prior to admission, showing lower risk of respiratory support upgrade with treatment.
Oct 2
PrEPPEP Basheer et al., Metabolites, doi:10.3390/metabo11100679
death, ↑13.0%, p=0.0003
Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia
Details   Retrospective 390 hospitalized patients in Israel, showing higher risk of mortality with prior aspirin use. Details of the analysis are not provided.
Oct 1
Late Zhao et al., Anesthesiology, doi:10.1097/ALN.0000000000003999
death, ↓43.0%, p=0.0006
Treatments Associated with Lower Mortality among Critically Ill COVID-19 Patients: A Retrospective Cohort Study
Details   Retrospective 2,070 hospitalized patients in the USA, showing lower mortality with aspirin treatment.
Sep 4
PrEPPEP Kim et al., Medicina, doi:10.3390/medicina57090931
death, ↑700.0%, p=0.03
Aspirin Is Related to Worse Clinical Outcomes of COVID-19
Details   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 u..
Sep 3
Late Al Harthi et al., Journal of Intensive Care Medicine, doi:10.1177/08850666221093229
death, ↓27.0%, p=0.03
Evaluation of Low-Dose Aspirin use among Critically Ill Patients with COVID-19: A Multicenter Propensity Score Matched Study
Details   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. ..
Sep 1
Late Karruli et al., Microbial Drug Resistance, doi:10.1089/mdr.2020.0489
death, ↓46.3%, p=0.63
Multidrug-Resistant Infections and Outcome of Critically Ill Patients with Coronavirus Disease 2019: A Single Center Experience
Details   Retrospective 32 ICU patients showing lower mortality with aspirin treatment, without statistical significance.
Aug 29
PrEPPEP Chow et al., Journal of Thrombosis and Haemostasis, doi:10.1111/jth.15517
death, ↓19.0%, p<0.005
Association of Pre-Hospital Antiplatelet Therapy with Survival in Patients Hospitalized with COVID-19: A Propensity Score-Matched Analysis
Details   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 18
PrEPPEP Ma et al., Drugs & Aging, doi:10.1007/s40266-021-00886-y
death, ↓9.0%, p=0.12
Sex Differences in Association Between Anti-Hypertensive Medications and Risk of COVID-19 in Middle-Aged and Older Adults
Details   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, howeve..
Jul 30
PrEPPEP Son et al., Medicine, doi:10.1097/MD.0000000000026670
death, ↓24.0%, p=0.52
Effect of aspirin on coronavirus disease 2019
Details   PSM retrospective case control study in South Korea, showing a trend towards lower mortality, but no significant differences with aspirin use.
Jul 30
Late Abdelwahab et al., Clinical Drug Investigation, doi:10.1007/s40261-021-01061-2
ventilation, ↑7.8%, p=0.93
Acetylsalicylic Acid Compared with Enoxaparin for the Prevention of Thrombosis and Mechanical Ventilation in COVID-19 Patients: A Retrospective Cohort Study
Details   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 20
Late Vahedian-Azimi et al., Identification of Biomarkers, New Treatments, and Vaccines for COVID-19, doi:10.1007/978-3-030-71697-4_17
death, ↓21.9%, p=0.56
Association of In-hospital Use of Statins, Aspirin, and Renin-Angiotensin-Aldosterone Inhibitors with Mortality and ICU Admission Due to COVID-19
Details   Retrospective 587 COVID+ hospitalized patients in Iran, showing no significant differences in outcomes with aspirin treatment.
Jun 30
Late Kevorkian et al., Journal of Infection, doi:10.1016/j.jinf.2021.02.008
progression, ↓95.7%, p=0.0005
Oral corticoid, aspirin, anticoagulant, colchicine, and furosemide to improve the outcome of hospitalized COVID-19 patients - the COCAA-COLA cohort study
Details   Observational study in France with 28 hospitalized patients treated with prednisone/furosemide/colchicine/salicylate/direct anti-Xa inhibitor, and 40 control patients, showing lower combined mortality, ventilation, or high-flow oxygen the..
Jun 17
PrEPPEP Oh et al., Yonsei Medical Journal, doi:10.3349/ymj.2021.62.7.577
death, ↓1.0%, p=0.95
Incidence and Mortality Associated with Cardiovascular Medication among Hypertensive COVID-19 Patients in South Korea
Details   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.
May 26
Late Pourhoseingholi et al., Research Square, doi:10.21203/ (Preprint)
death, ↑32.0%, p=0.04
Case Characteristics, Clinical Data, And Outcomes of Hospitalized COVID-19 Patients In Qom Province, Iran: A Prospective Cohort Study
Details   Prospective study of 2,468 hospitalized COVID-19 patients in Iran, showing higher mortality with aspirin treatment. IR.MUQ.REC.1399.013.
May 26
PrEPPEP Pan et al., Heart & Lung, doi:10.1016/j.hrtlng.2021.04.010
death, ↑13.0%, p=0.63
Pre-hospital antiplatelet medication use on COVID-19 disease severity
Details   Retrospective 762 COVID+ hospitalized patients in the USA, 239 on antiplatelet medication (199 aspirin), showing no significant differences in outcomes.
May 19
Late Sahai et al., Vascular Medicine, doi:10.1177/1358863X211012754
death, ↓13.2%, p=0.53
Effect of aspirin on short-term outcomes in hospitalized patients with COVID-19
Details   PSM retrospective 1,994 PCR+ patients in the USA, not showing a significant difference in mortality with aspirin treatment.
Apr 30
Late Elhadi et al., PLOS ONE, doi:10.1371/journal.pone.0251085
death, ↓9.7%, p=0.50
Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
Details   Prospective study of 465 COVID-19 ICU patients in Libya showing no significant differences with treatment.
Apr 29
Late Haji Aghajani et al., Journal of Medical Virology, doi:10.1002/jmv.27053
death, ↓24.7%, p=0.04
Decreased in-hospital mortality associated with aspirin administration in hospitalized patients due to severe COVID-19
Details   Retrospective 991 hospitalized patients in Iran, showing lower mortality with aspirin treatment.
Apr 7
PrEPPEP Mulhem et al., BMJ Open, doi:10.1136/bmjopen-2020-042042
death, ↑13.9%, p=0.21
3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study
Details   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..
Apr 1
Late Chow et al., Anesthesia & Analgesia, doi:10.1213/ANE.0000000000005292
death, ↓47.0%, p=0.02
Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019
Details   Retrospective 412 hospitalized patients, 98 treated with aspirin, showing lower mortality, ventilation, and ICU admission with treatment.
Mar 31
Late Mura et al., Signal Transduction and Targeted Therapy, doi:10.1038/s41392-021-00689-y (preprint 3/31/2021)
death, ↓15.4%, p=0.08
Real-world evidence for improved outcomes with histamine antagonists and aspirin in 22,560 COVID-19 patients
Details   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 combin..
Feb 23
PrEPPEP Merzon et al., The FEBS Journal, doi:10.1111/febs.15784
cases, ↓27.6%, p=0.04
The use of aspirin for primary prevention of cardiovascular disease is associated with a lower likelihood of COVID-19 infection
Details   Retrospective 10,477 patients in Israel, showing lower risk of COVID-19 cases with existing aspiring use.
Feb 12
Late Liu et al., Medicine, doi:10.1097/MD.0000000000024544
death, ↓75.0%, p=0.03
Effect of low-dose aspirin on mortality and viral duration of the hospitalized adults with COVID-19
Details   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 11
PrEPPEP Osborne et al., PloS ONE, doi:10.1371/journal.pone.0246825
death, ↓59.4%, p<0.0001
Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration
Details   Retrospective PSM analysis of pre-existing aspirin use in the USA, showing lower mortality with treatment.
Jan 21
Late Meizlish et al., American Journal of Hematology, doi:10.1002/ajh.26102
death, ↓47.8%, p=0.004
Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: A propensity score-matched analysis
Details   Retrospective 638 matched hospitalized patients in the USA, 319 treated with aspirin, showing lower mortality with treatment.
Dec 18
PrEPPEP Yuan et al., Journal of Cellular and Molecular Medicine, doi:10.1111/jcmm.16198
death, ↓4.4%, p=0.89
Mortality and pre-hospitalization use of low-dose aspirin in COVID-19 patients with coronary artery disease
Details   Retrospective 183 hospitalized patients in China, 52 taking low-dose aspirin prior to hospitalization, showing no significant difference with treatment.
Nov 29
PrEPPEP Formiga et al., Internal and Emergency Medicine, doi:10.1007/s11739-021-02870-1
death, ↑3.4%, p=0.48
Does admission acetylsalicylic acid uptake in hospitalized COVID-19 patients have a protective role? Data from the Spanish SEMI-COVID-19 Registry
Details   Retrospective 20,641 hospitalized patients in Spain, showing no significant difference in outcomes with existing aspirin use.
Nov 5
Late Goshua et al., Blood, doi:10.1182/blood-2020-143349
death, ↓35.0%, p=0.04
Admission Rothman Index, Aspirin, and Intermediate Dose Anticoagulation Effects on Outcomes in COVID-19: A Multi-Site Propensity Matched Analysis
Details   PSM retrospective 2,785 hospitalized patients in the USA, showing lower mortality and higher ventilation and ICU admission with aspirin treatment.
Oct 31
Late Husain et al., ResearchGate, doi:10.13140/RG.2.2.26038.93762/2 (Preprint)
death, ↓80.3%, p=0.55
Beneficial effect of low dose aspirin (Acetyl salicylic acid) in adult Covid-19 patients: a retrospective observational study in Bangladesh
Details   Retrospective 42 patients in Bangladesh, 11 treated with aspirin, showing fewer complications with treatment.
Sep 9
Late Alamdari et al., Tohoku J. Exp. Med., 2020, 252, 73-84, doi:10.1620/tjem.252.73
death, ↑27.7%, p=0.52
Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran
Details   Retrospective 459 patients in Iran, 53 treated with aspirin, showing no significant difference with treatment.
Jul 14
PrEPPEP Wang et al., Journal of Hematology & Oncology, doi:10.1186/s13045-020-00934-x
death, ↓57.7%, p=0.43
A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward
Details   Retrospective 58 multiple myeloma COVID-19 patients in the USA, showing no significant difference with aspirin treatment.
May 4
PrEPPEP Huh et al., medRxiv, doi:10.1101/2020.05.04.20089904 (Preprint)
cases, ↓71.0%, p=0.001
Association of previous medications with the risk of COVID-19: a nationwide claims-based study from South Korea
Details   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).
Please send us corrections, updates, or comments. Vaccines and treatments are both valuable and complementary. All practical, effective, and safe means should be used. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases mortality, morbidity, collateral damage, and the risk of endemic status. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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