Aspirin for COVID-19: real-time analysis of all 13 studies

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Database of all aspirin COVID-19 studies. Submit updates/corrections.


Sep 4	PrEP	Kim et al., Medicina, doi:10.3390/medicina57090931 (Peer Reviewed)	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 4	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Kim et al., Medicina, doi:10.3390/medicina57090931 (Peer Reviewed)
	Aspirin Is Related to Worse Clinical Outcomes of COVID-19
	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 use after COVID-19 was related to a higher risk of oxygen therapy. risk of death, 700.0% higher, RR 8.00, p = 0.03, treatment 6 of 15 (40.0%), control 1 of 20 (5.0%), PSM, prior aspirin use. risk of mechanical ventilation, 433.3% higher, RR 5.33, p = 0.14, treatment 4 of 15 (26.7%), control 1 of 20 (5.0%), PSM, prior aspirin use. risk of ICU admission, 433.3% higher, RR 5.33, p = 0.14, treatment 4 of 15 (26.7%), control 1 of 20 (5.0%), PSM, prior aspirin use. risk of COVID-19 case, 33.4% lower, RR 0.67, p = 0.23, treatment 15 of 136 (11.0%), control 20 of 136 (14.7%), adjusted, OR converted to RR, PSM, logistic regression, prior aspirin use. risk of death, 33.7% lower, RR 0.66, p = 0.22, treatment 14 of 124 (11.3%), control 23 of 135 (17.0%), PSM, aspirin treatment after diagnosis. risk of mechanical ventilation, 102.2% higher, RR 2.02, p = 0.16, treatment 13 of 124 (10.5%), control 7 of 135 (5.2%), PSM, aspirin treatment after diagnosis. risk of ICU admission, 90.5% higher, RR 1.91, p = 0.36, treatment 7 of 124 (5.6%), control 4 of 135 (3.0%), PSM, aspirin treatment after diagnosis. Kim et al., 9/4/2021, retrospective, propensity score matching, South Korea, Asia, peer-reviewed, 7 authors.
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Sep 3	Late	Al Harthi et al., Research Square, doi:10.21203/rs.3.rs-872891/v1 (Preprint)	death, ↓27.0%, p=0.03	Evaluation of low-dose aspirin use among COVID-19 critically ill patients: 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 3	Details Source PDF Late treatment study Late treatment study
	Al Harthi et al., Research Square, doi:10.21203/rs.3.rs-872891/v1 (Preprint)
	Evaluation of low-dose aspirin use among COVID-19 critically ill patients: A Multicenter Propensity Score Matched Study
	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. Authors note that the use of aspirin during an ICU stay should be tailored to each patient. risk of death, 27.0% lower, RR 0.73, p = 0.03, treatment 98 of 176 (55.7%), control 107 of 173 (61.8%), adjusted, in-hospital mortality, multivariable Cox proportional hazards. risk of death, 14.0% lower, RR 0.86, p = 0.30, treatment 95 of 176 (54.0%), control 97 of 175 (55.4%), adjusted, day 30, multivariable Cox proportional hazards. Al Harthi et al., 9/3/2021, retrospective, propensity score matching, Saudi Arabia, Middle East, preprint, 20 authors.
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Aug 29	PrEP	Chow et al., Journal of Thrombosis and Haemostasis, doi:10.1111/jth.15517 (Peer Reviewed)	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 29	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Chow et al., Journal of Thrombosis and Haemostasis, doi:10.1111/jth.15517 (Peer Reviewed)
	Association of Pre-Hospital Antiplatelet Therapy with Survival in Patients Hospitalized with COVID-19: A Propensity Score-Matched Analysis
	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. risk of death, 19.0% lower, RR 0.81, p < 0.005, treatment 1280 of 6781 (18.9%), control 2271 of 10566 (21.5%), adjusted, Kaplan Meier. risk of mechanical ventilation, 2.8% lower, RR 0.97, p = 0.21, treatment 2122 of 6781 (31.3%), control 3403 of 10566 (32.2%). Chow et al., 8/29/2021, retrospective, propensity score matching, USA, North America, peer-reviewed, 12 authors.
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Jul 30	Late	Abdelwahab et al., Clinical Drug Investigation, doi:10.1007/s40261-021-01061-2 (Peer Reviewed)	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 30	Details Source PDF Late treatment study Late treatment study
	Abdelwahab et al., Clinical Drug Investigation, doi:10.1007/s40261-021-01061-2 (Peer Reviewed)
	Acetylsalicylic Acid Compared with Enoxaparin for the Prevention of Thrombosis and Mechanical Ventilation in COVID-19 Patients: A Retrospective Cohort Study
	Retrospective 225 hospitalized patients in Egypt, showing significantly lower thromboembolic events with aspirin treatment, but no significant difference in the need for mechanical ventilation. risk of mechanical ventilation, 7.8% higher, RR 1.08, p = 0.93, treatment 11 of 31 (35.5%), control 6 of 36 (16.7%), adjusted, OR converted to RR. Abdelwahab et al., 7/30/2021, retrospective, Egypt, Africa, peer-reviewed, 17 authors.
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Jun 8	Late	Horby et al., medRxiv, doi:10.1101/2021.06.08.21258132 (Preprint)	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 very late stage (9 days from symptom onset) hospitalized patients, not showing a significant difference in mortality with treatment. A statistically significant increased chance of hospital discharge was found for treatment <= ..
Jun 8	Details Source PDF Late treatment study Late treatment study
	Horby et al., medRxiv, doi:10.1101/2021.06.08.21258132 (Preprint)
	Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
	RCT 14,892 very late stage (9 days from symptom onset) hospitalized patients, not showing a significant difference in mortality with treatment. A statistically significant increased chance of hospital discharge was found for treatment <= 7 days from symptom onset (supplement page 52). Only 7% of patients were not receiving thromboprophylaxis. Authors note that the lack of benefit seen may be because there was no significant additional benefit given the high rates of antithrombotic therapy with LMWH. Authors also note that potential benefit may depend on treatment delay, especially if thrombi had developed before admission. Lower RR is shown for patients not on LMWH (0.83), and patients treated <= 7 days from onset (0.93). Results restricted to earlier treatment times are not provided. Patients already receiving aspirin were excluded. NCT04381936. risk of death, 4.0% lower, RR 0.96, p = 0.35, treatment 1222 of 7351 (16.6%), control 1299 of 7541 (17.2%). risk of death, 17.0% lower, RR 0.83, p = 0.11, treatment 129 of 466 (27.7%), control 169 of 513 (32.9%), no LMWH, supplement page 54. risk of death, 7.0% lower, RR 0.93, p = 0.25, treatment 1222 of 7351 (16.6%), control 1299 of 7541 (17.2%), <=7 days from onset, supplement page 52. risk of mechanical ventilation, 5.0% lower, RR 0.95, p = 0.32, treatment 772 of 6993 (11.0%), control 829 of 7169 (11.6%). Horby et al., 6/8/2021, Randomized Controlled Trial, United Kingdom, Europe, preprint, 35 authors.
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May 19	Late	Sahai et al., Vascular Medicine, doi:10.1177/1358863X211012754 (Peer Reviewed)	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.
May 19	Details Source PDF Late treatment study Late treatment study
	Sahai et al., Vascular Medicine, doi:10.1177/1358863X211012754 (Peer Reviewed)
	Effect of aspirin on short-term outcomes in hospitalized patients with COVID-19
	PSM retrospective 1,994 PCR+ patients in the USA, not showing a significant difference in mortality with aspirin treatment. risk of death, 13.2% lower, RR 0.87, p = 0.53, treatment 33 of 248 (13.3%), control 38 of 248 (15.3%). Sahai et al., 5/19/2021, retrospective, propensity score matching, USA, North America, peer-reviewed, 18 authors.
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Apr 7	PrEP	Mulhem et al., BMJ Open, doi:10.1136/bmjopen-2020-042042 (Peer Reviewed)	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 7	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Mulhem et al., BMJ Open, doi:10.1136/bmjopen-2020-042042 (Peer Reviewed)
	3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study
	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 [2.44-3.83]) suggest significant confounding by indication and confounding by time. risk of death, 13.9% higher, RR 1.14, p = 0.21, treatment 300 of 1354 (22.2%), control 216 of 1865 (11.6%), adjusted, OR converted to RR, Table S1, logistic regression. Mulhem et al., 4/7/2021, retrospective, database analysis, USA, North America, peer-reviewed, 3 authors.
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Apr 1	Late	Chow et al., Anesthesia & Analgesia, doi:10.1213/ANE.0000000000005292 (Peer Reviewed)	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.
Apr 1	Details Source PDF Late treatment study Late treatment study
	Chow et al., Anesthesia & Analgesia, doi:10.1213/ANE.0000000000005292 (Peer Reviewed)
	Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019
	Retrospective 412 hospitalized patients, 98 treated with aspirin, showing lower mortality, ventilation, and ICU admission with treatment. risk of death, 47.0% lower, RR 0.53, p = 0.02, treatment 26 of 98 (26.5%), control 73 of 314 (23.2%), adjusted, Cox proportional hazards. risk of mechanical ventilation, 44.0% lower, RR 0.56, p = 0.007, treatment 35 of 98 (35.7%), control 152 of 314 (48.4%), adjusted, Cox proportional hazards. risk of ICU admission, 43.0% lower, RR 0.57, p = 0.007, treatment 38 of 98 (38.8%), control 160 of 314 (51.0%), adjusted, Cox proportional hazards. Chow et al., 4/1/2021, retrospective, USA, North America, peer-reviewed, 38 authors.
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Mar 31	Late	Mura et al., Research Square, doi:10.21203/rs.3.rs-369927/v1 (Preprint)	death, ↓20.3%, p=0.001	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..
Mar 31	Details Source PDF Late treatment study Late treatment study
	Mura et al., Research Square, doi:10.21203/rs.3.rs-369927/v1 (Preprint)
	Real-world Evidence for Improved Outcomes with Histamine Antagonists and Aspirin in 22,560 COVID-19 Patients
	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 combination of both. risk of death, 20.3% lower, RR 0.80, p = 0.001, treatment 527, control 527, OR converted to RR, aspirin only, control prevalence approximated with overall prevalence. risk of death, 37.3% lower, RR 0.63, p < 0.001, treatment 305, control 305, OR converted to RR, famotidine and aspirin, control prevalence approximated with overall prevalence. Mura et al., 3/31/2021, retrospective, database analysis, multiple countries, multiple regions, preprint, 6 authors.
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Feb 12	Late	Liu et al., Medicine, doi:10.1097/MD.0000000000024544 (Peer Reviewed)	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 12	Details Source PDF Late treatment study Late treatment study
	Liu et al., Medicine, doi:10.1097/MD.0000000000024544 (Peer Reviewed)
	Effect of low-dose aspirin on mortality and viral duration of the hospitalized adults with COVID-19
	Retrospective PSM analysis of 232 hospitalized patients, 28 treated with aspirin, showing lower mortality with treatment. There was no significant difference in viral clearance. risk of death, 75.0% lower, RR 0.25, p = 0.03, treatment 2 of 28 (7.1%), control 11 of 204 (5.4%), adjusted, 60 days, KM, PSM. risk of death, 81.0% lower, RR 0.19, p = 0.02, treatment 1 of 28 (3.6%), control 9 of 204 (4.4%), adjusted, 30 days, KM, PSM. time to viral-, 1.9% higher, relative time 1.02, p = 0.94, treatment 24, control 24, PSM. Liu et al., 2/12/2021, retrospective, propensity score matching, China, Asia, peer-reviewed, 8 authors.
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Feb 11	PrEP	Osborne et al., PloS ONE, doi:10.1371/journal.pone.0246825 (Peer Reviewed)	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.
Feb 11	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Osborne et al., PloS ONE, doi:10.1371/journal.pone.0246825 (Peer Reviewed)
	Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration
	Retrospective PSM analysis of pre-existing aspirin use in the USA, showing lower mortality with treatment. risk of death, 59.4% lower, RR 0.41, p < 0.001, treatment 272 of 6300 (4.3%), control 661 of 6300 (10.5%), OR converted to RR, 30 days, PSM. risk of death, 60.5% lower, RR 0.40, p < 0.001, treatment 170 of 6814 (2.5%), control 427 of 6814 (6.3%), OR converted to RR, 14 days, PSM. Osborne et al., 2/11/2021, retrospective, propensity score matching, USA, North America, peer-reviewed, 6 authors.
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Jan 21	Late	Meizlish et al., American Journal of Hematology, doi:10.1002/ajh.26102 (Peer Reviewed)	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.
Jan 21	Details Source PDF Late treatment study Late treatment study
	Meizlish et al., American Journal of Hematology, doi:10.1002/ajh.26102 (Peer Reviewed)
	Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: A propensity score-matched analysis
	Retrospective 638 matched hospitalized patients in the USA, 319 treated with aspirin, showing lower mortality with treatment. risk of death, 47.8% lower, RR 0.52, p = 0.004, treatment 319, control 319, PSM. Meizlish et al., 1/21/2021, retrospective, propensity score matching, USA, North America, peer-reviewed, 22 authors.
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Dec 18 2020	PrEP	Yuan et al., Journal of Cellular and Molecular Medicine, doi:10.1111/jcmm.16198 (Peer Reviewed)	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.
Dec 18 2020	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Yuan et al., Journal of Cellular and Molecular Medicine, doi:10.1111/jcmm.16198 (Peer Reviewed)
	Mortality and pre-hospitalization use of low-dose aspirin in COVID-19 patients with coronary artery disease
	Retrospective 183 hospitalized patients in China, 52 taking low-dose aspirin prior to hospitalization, showing no significant difference with treatment. risk of death, 4.4% lower, RR 0.96, p = 0.89, treatment 11 of 52 (21.2%), control 29 of 131 (22.1%), OR converted to RR, mutivariate. Yuan et al., 12/18/2020, retrospective, China, Asia, peer-reviewed, 6 authors.
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Aspirin	Molnupiravir
Bamlanivimab	Nigella Sativa
Bromhexine	Nitazoxanide
Budesonide	Povidone-Iod..
Casirivimab/i..	Probiotics
Colchicine	Proxalutamide
Conv. Plasma	Quercetin
Curcumin	Remdesivir
Favipiravir	Sotrovimab
Fluvoxamine	Vitamin A
Hydroxychloro..	Vitamin C
Iota-carragee..	Vitamin D
Ivermectin	Zinc
Melatonin

Other	Adoption