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Aspirin for COVID-19: real-time meta analysis of 44 studies
Covid Analysis, May 23, 2022, DRAFT
https://c19aspirin.com/meta.html
0 0.5 1 1.5+ All studies 14% 44 120,131 Improvement, Studies, Patients Relative Risk Mortality 13% 39 106,422 Ventilation 5% 8 33,775 ICU admission -13% 7 3,103 Hospitalization -2% 4 3,475 Progression 13% 4 1,406 Recovery 9% 3 16,018 Cases 13% 6 10,749 Viral clearance 9% 2 710 RCTs 7% 3 16,256 RCT mortality 8% 2 15,976 Peer-reviewed 14% 40 96,042 Prophylaxis 9% 22 93,296 Early 67% 1 280 Late 20% 21 26,555 Aspirin for COVID-19 c19aspirin.com May 2022 Favorsaspirin Favorscontrol after exclusions
Statistically significant improvement is seen for mortality. 20 studies from 8 different countries show statistically significant improvements in isolation (15 for the most serious outcome).
Meta analysis using the most serious outcome reported shows 14% [7‑20%] improvement. Results are worse for Randomized Controlled Trials, similar after exclusions, and similar for peer-reviewed studies. Early treatment is more effective than late treatment.
Results are robust — in exclusion sensitivity analysis 14 of 44 studies must be excluded to avoid finding statistically significant efficacy in pooled analysis.
0 0.5 1 1.5+ All studies 14% 44 120,131 Improvement, Studies, Patients Relative Risk Mortality 13% 39 106,422 Ventilation 5% 8 33,775 ICU admission -13% 7 3,103 Hospitalization -2% 4 3,475 Progression 13% 4 1,406 Recovery 9% 3 16,018 Cases 13% 6 10,749 Viral clearance 9% 2 710 RCTs 7% 3 16,256 RCT mortality 8% 2 15,976 Peer-reviewed 14% 40 96,042 Prophylaxis 9% 22 93,296 Early 67% 1 280 Late 20% 21 26,555 Aspirin for COVID-19 c19aspirin.com May 2022 Favorsaspirin Favorscontrol after exclusions
Studies to date do not show a significant benefit for mechanical ventilation and ICU admission. Benefit may be more likely without coadministered anticoagulants. The RECOVERY RCT shows 4% [-4‑11%] lower mortality for all patients, however when restricting to non-LMWH patients there was 17% [-4‑34%] improvement, consistent with the mortality results of all studies, 13% [6‑19%], and the 16% improvement in the REMAP-CAP RCT.
While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 5% of aspirin studies show zero events in the treatment arm. Multiple treatments are typically used in combination, and other treatments are significantly more effective.
No treatment, vaccine, or intervention is 100% available and effective for all variants. All practical, effective, and safe means should be used. Denying the efficacy of treatments increases mortality, morbidity, collateral damage, and endemic risk.
All data to reproduce this paper and sources are in the appendix. [Banaser] present another meta analysis for aspirin, showing significant improvements for mortality and mechanical ventilation.
Highlights
Aspirin reduces risk for COVID-19 with very high confidence for mortality and in pooled analysis, low confidence for recovery and viral clearance, and very low confidence for cases. Benefit may be more likely without coadministered anticoagulants.
We show traditional outcome specific analyses and combined evidence from all studies, incorporating treatment delay, a primary confounding factor in COVID-19 studies.
Real-time updates and corrections, transparent analysis with all results in the same format, consistent protocol for 42 treatments.
A
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Connors (DB RCT) 67% 0.33 [0.01-7.96] hosp. 0/144 1/136 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.5 Early treatment 67% 0.33 [0.01-7.96] 0/144 1/136 67% improvement Alamdari -28% 1.28 [0.67-2.43] death 9/53 54/406 Improvement, RR [CI] Treatment Control Husain 80% 0.20 [0.01-3.55] death 0/11 3/31 Goshua (PSM) 35% 0.65 [0.42-0.98] death 319 (n) 319 (n) Meizlish (PSM) 48% 0.52 [0.34-0.81] death 319 (n) 319 (n) Liu (PSM) 75% 0.25 [0.07-0.87] death 2/28 11/204 Mura (PSM) 15% 0.85 [0.69-1.01] death 527 (n) 527 (n) Chow 47% 0.53 [0.31-0.90] death 26/98 73/314 Haji Aghajani 25% 0.75 [0.57-0.99] death 336 (n) 655 (n) Elhadi (ICU) 10% 0.90 [0.67-1.21] death 22/40 259/425 ICU patients Sahai (PSM) 13% 0.87 [0.56-1.34] death 33/248 38/248 Pourhoseingholi -32% 1.32 [1.02-1.71] death 71/290 268/2,178 Vahedian-Azimi 22% 0.78 [0.33-1.74] death 13/337 28/250 Abdelwahab -8% 1.08 [0.15-3.82] ventilation 11/31 6/36 Karruli (ICU) 46% 0.54 [0.09-3.13] death 1/5 22/27 ICU patients Al Harthi (PSM) 27% 0.73 [0.56-0.97] death 98/176 107/173 Kim (PSM) 34% 0.66 [0.36-1.23] death 14/124 23/135 Zhao 43% 0.57 [0.41-0.78] death 121/473 140/473 RECOVERY (RCT) 4% 0.96 [0.89-1.04] death 7,351 (n) 7,541 (n) Mustafa 44% 0.56 [0.21-1.51] death 4/66 41/378 Bradbury (RCT) 16% 0.84 [0.70-1.00] death 165/563 170/521 Chow (IPW) 13% 0.87 [0.81-0.93] death Tau​2 = 0.02, I​2 = 66.2%, p < 0.0001 Late treatment 20% 0.80 [0.73-0.89] 590/11,395 1,243/15,160 20% improvement Huh 71% 0.29 [0.14-0.58] cases population-based cohort Improvement, RR [CI] Treatment Control Wang 58% 0.42 [0.01-1.98] death 1/9 13/49 Yuan 4% 0.96 [0.47-1.72] death 11/52 29/131 Osborne (PSM) 59% 0.41 [0.35-0.48] death 272/6,300 661/6,300 Merzon 28% 0.72 [0.53-0.99] cases 73/1,621 589/8,856 Mulhem -14% 1.14 [0.93-1.40] death 300/1,354 216/1,865 Pan -13% 1.13 [0.70-1.82] death 239 (n) 523 (n) Oh 1% 0.99 [0.65-1.50] death n/a n/a Son (PSM) 24% 0.76 [0.34-1.71] death case control Ma (PSM) 9% 0.91 [0.82-1.02] death Chow (PSM) 19% 0.81 [0.76-0.87] death 1,280/6,781 2,271/10,566 Kim (PSM) -700% 8.00 [1.07-59.6] death 6/15 1/20 Basheer -13% 1.13 [1.05-1.21] death 45/140 29/250 Sisinni -7% 1.07 [0.89-1.29] death 93/253 251/731 Pérez-Segura -49% 1.49 [1.20-1.80] death 66/155 183/608 Sullerot (IPW) -10% 1.10 [0.81-1.49] death 101/301 224/746 Monserrat V.. (PSM) -31% 1.31 [1.01-1.71] death n/a n/a Levy 26% 0.74 [0.49-1.10] death/hosp. 29/159 178/690 Nimer 4% 0.96 [0.69-1.33] hosp. 83/427 136/1,721 Gogtay -6% 1.06 [0.51-1.89] death 12/38 21/87 Campbell (IPW) 3% 0.97 [0.95-1.00] death 419 (n) 20,311 (n) Lal 11% 0.89 [0.82-0.97] death 4,691 (n) 16,888 (n) Tau​2 = 0.05, I​2 = 90.8%, p = 0.11 Prophylaxis 9% 0.91 [0.81-1.02] 2,372/22,954 4,802/70,342 9% improvement All studies 14% 0.86 [0.80-0.93] 2,962/34,493 6,046/85,638 14% improvement 44 aspirin COVID-19 studies c19aspirin.com May 2022 Tau​2 = 0.03, I​2 = 85.5%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) Favors aspirin Favors control
Figure 1. A. Random effects meta-analysis. This plot shows pooled effects, discussion can be found in the heterogeneity section, and results for specific outcomes can be found in the individual outcome analyses. Effect extraction is pre-specified, using the most serious outcome reported. For details of effect extraction see the appendix. B. Scatter plot showing the distribution of effects reported in studies. C. History of all reported effects (chronological within treatment stages).
Introduction
We analyze all significant studies concerning the use of aspirin for COVID-19. Search methods, inclusion criteria, effect extraction criteria (more serious outcomes have priority), all individual study data, PRISMA answers, and statistical methods are detailed in Appendix 1. We present random effects meta-analysis results for all studies, for studies within each treatment stage, for individual outcomes, for peer-reviewed studies, for Randomized Controlled Trials (RCTs), and after exclusions.
Figure 2 shows stages of possible treatment for COVID-19. Prophylaxis refers to regularly taking medication before becoming sick, in order to prevent or minimize infection. Early Treatment refers to treatment immediately or soon after symptoms appear, while Late Treatment refers to more delayed treatment.
Figure 2. Treatment stages.
Results
Figure 3 shows a visual overview of the results, with details in Table 1 and Table 2. Figure 4, 5, 6, 7, 8, 9, 10, 11, 12, and 13 show forest plots for a random effects meta-analysis of all studies with pooled effects, mortality results, ventilation, ICU admission, hospitalization, progression, recovery, cases, viral clearance, and peer reviewed studies.
0 0.5 1 1.5+ ALL STUDIES MORTALITY VENTILATION ICU ADMISSION HOSPITALIZATION PROGRESSION RECOVERY CASES VIRAL CLEARANCE RANDOMIZED CONTROLLED TRIALS RCT MORTALITY PEER-REVIEWED After Exclusions ALL STUDIES All Prophylaxis Early Late Aspirin for COVID-19 C19ASPIRIN.COM MAY 2022
Figure 3. Overview of results.
Treatment timeNumber of studies reporting positive effects Total number of studiesPercentage of studies reporting positive effects Random effects meta-analysis results
Early treatment 1 1 100% 67% improvement
RR 0.33 [0.01‑7.96]
p = 0.5
Late treatment 18 21 85.7% 20% improvement
RR 0.80 [0.73‑0.89]
p < 0.0001
Prophylaxis 13 22 59.1% 9% improvement
RR 0.91 [0.81‑1.02]
p = 0.11
All studies 32 44 72.7% 14% improvement
RR 0.86 [0.80‑0.93]
p < 0.0001
Table 1. Results by treatment stage.
Studies Early treatment Late treatment Prophylaxis PatientsAuthors
All studies 4467% [-696‑99%]20% [11‑27%]9% [-2‑19%] 120,131 637
With exclusions 4067% [-696‑99%]21% [12‑29%]10% [-1‑20%] 115,544 592
Peer-reviewed 4067% [-696‑99%]22% [15‑29%]6% [-6‑17%] 96,042 604
Randomized Controlled TrialsRCTs 367% [-696‑99%]8% [-4‑19%] 16,256 101
Table 2. Results by treatment stage for all studies and with different exclusions.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Connors (DB RCT) 67% 0.33 [0.01-7.96] hosp. 0/144 1/136 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.5 Early treatment 67% 0.33 [0.01-7.96] 0/144 1/136 67% improvement Alamdari -28% 1.28 [0.67-2.43] death 9/53 54/406 Improvement, RR [CI] Treatment Control Husain 80% 0.20 [0.01-3.55] death 0/11 3/31 Goshua (PSM) 35% 0.65 [0.42-0.98] death 319 (n) 319 (n) Meizlish (PSM) 48% 0.52 [0.34-0.81] death 319 (n) 319 (n) Liu (PSM) 75% 0.25 [0.07-0.87] death 2/28 11/204 Mura (PSM) 15% 0.85 [0.69-1.01] death 527 (n) 527 (n) Chow 47% 0.53 [0.31-0.90] death 26/98 73/314 Haji Aghajani 25% 0.75 [0.57-0.99] death 336 (n) 655 (n) Elhadi (ICU) 10% 0.90 [0.67-1.21] death 22/40 259/425 ICU patients Sahai (PSM) 13% 0.87 [0.56-1.34] death 33/248 38/248 Pourhoseingholi -32% 1.32 [1.02-1.71] death 71/290 268/2,178 Vahedian-Azimi 22% 0.78 [0.33-1.74] death 13/337 28/250 Abdelwahab -8% 1.08 [0.15-3.82] ventilation 11/31 6/36 Karruli (ICU) 46% 0.54 [0.09-3.13] death 1/5 22/27 ICU patients Al Harthi (PSM) 27% 0.73 [0.56-0.97] death 98/176 107/173 Kim (PSM) 34% 0.66 [0.36-1.23] death 14/124 23/135 Zhao 43% 0.57 [0.41-0.78] death 121/473 140/473 RECOVERY (RCT) 4% 0.96 [0.89-1.04] death 7,351 (n) 7,541 (n) Mustafa 44% 0.56 [0.21-1.51] death 4/66 41/378 Bradbury (RCT) 16% 0.84 [0.70-1.00] death 165/563 170/521 Chow (IPW) 13% 0.87 [0.81-0.93] death Tau​2 = 0.02, I​2 = 66.2%, p < 0.0001 Late treatment 20% 0.80 [0.73-0.89] 590/11,395 1,243/15,160 20% improvement Huh 71% 0.29 [0.14-0.58] cases population-based cohort Improvement, RR [CI] Treatment Control Wang 58% 0.42 [0.01-1.98] death 1/9 13/49 Yuan 4% 0.96 [0.47-1.72] death 11/52 29/131 Osborne (PSM) 59% 0.41 [0.35-0.48] death 272/6,300 661/6,300 Merzon 28% 0.72 [0.53-0.99] cases 73/1,621 589/8,856 Mulhem -14% 1.14 [0.93-1.40] death 300/1,354 216/1,865 Pan -13% 1.13 [0.70-1.82] death 239 (n) 523 (n) Oh 1% 0.99 [0.65-1.50] death n/a n/a Son (PSM) 24% 0.76 [0.34-1.71] death case control Ma (PSM) 9% 0.91 [0.82-1.02] death Chow (PSM) 19% 0.81 [0.76-0.87] death 1,280/6,781 2,271/10,566 Kim (PSM) -700% 8.00 [1.07-59.6] death 6/15 1/20 Basheer -13% 1.13 [1.05-1.21] death 45/140 29/250 Sisinni -7% 1.07 [0.89-1.29] death 93/253 251/731 Pérez-Segura -49% 1.49 [1.20-1.80] death 66/155 183/608 Sullerot (IPW) -10% 1.10 [0.81-1.49] death 101/301 224/746 Monserrat V.. (PSM) -31% 1.31 [1.01-1.71] death n/a n/a Levy 26% 0.74 [0.49-1.10] death/hosp. 29/159 178/690 Nimer 4% 0.96 [0.69-1.33] hosp. 83/427 136/1,721 Gogtay -6% 1.06 [0.51-1.89] death 12/38 21/87 Campbell (IPW) 3% 0.97 [0.95-1.00] death 419 (n) 20,311 (n) Lal 11% 0.89 [0.82-0.97] death 4,691 (n) 16,888 (n) Tau​2 = 0.05, I​2 = 90.8%, p = 0.11 Prophylaxis 9% 0.91 [0.81-1.02] 2,372/22,954 4,802/70,342 9% improvement All studies 14% 0.86 [0.80-0.93] 2,962/34,493 6,046/85,638 14% improvement 44 aspirin COVID-19 studies c19aspirin.com May 2022 Tau​2 = 0.03, I​2 = 85.5%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) Favors aspirin Favors control
Figure 4. Random effects meta-analysis for all studies with pooled effects. This plot shows pooled effects, discussion can be found in the heterogeneity section, and results for specific outcomes can be found in the individual outcome analyses. Effect extraction is pre-specified, using the most serious outcome reported. For details of effect extraction see the appendix.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Alamdari -28% 1.28 [0.67-2.43] 9/53 54/406 Improvement, RR [CI] Treatment Control Husain 80% 0.20 [0.01-3.55] 0/11 3/31 Goshua (PSM) 35% 0.65 [0.42-0.98] 319 (n) 319 (n) Meizlish (PSM) 48% 0.52 [0.34-0.81] 319 (n) 319 (n) Liu (PSM) 75% 0.25 [0.07-0.87] 2/28 11/204 Mura (PSM) 15% 0.85 [0.69-1.01] 527 (n) 527 (n) Chow 47% 0.53 [0.31-0.90] 26/98 73/314 Haji Aghajani 25% 0.75 [0.57-0.99] 336 (n) 655 (n) Elhadi (ICU) 10% 0.90 [0.67-1.21] 22/40 259/425 ICU patients Sahai (PSM) 13% 0.87 [0.56-1.34] 33/248 38/248 Pourhoseingholi -32% 1.32 [1.02-1.71] 71/290 268/2,178 Vahedian-Azimi 22% 0.78 [0.33-1.74] 13/337 28/250 Karruli (ICU) 46% 0.54 [0.09-3.13] 1/5 22/27 ICU patients Al Harthi (PSM) 27% 0.73 [0.56-0.97] 98/176 107/173 Kim (PSM) 34% 0.66 [0.36-1.23] 14/124 23/135 Zhao 43% 0.57 [0.41-0.78] 121/473 140/473 RECOVERY (RCT) 4% 0.96 [0.89-1.04] 7,351 (n) 7,541 (n) Mustafa 44% 0.56 [0.21-1.51] 4/66 41/378 Bradbury (RCT) 16% 0.84 [0.70-1.00] 165/563 170/521 Chow (IPW) 13% 0.87 [0.81-0.93] Tau​2 = 0.02, I​2 = 67.8%, p < 0.0001 Late treatment 20% 0.80 [0.72-0.88] 579/11,364 1,237/15,124 20% improvement Wang 58% 0.42 [0.01-1.98] 1/9 13/49 Improvement, RR [CI] Treatment Control Yuan 4% 0.96 [0.47-1.72] 11/52 29/131 Osborne (PSM) 59% 0.41 [0.35-0.48] 272/6,300 661/6,300 Merzon 62% 0.38 [0.02-4.94] 1/21 6/91 Mulhem -14% 1.14 [0.93-1.40] 300/1,354 216/1,865 Pan -13% 1.13 [0.70-1.82] 239 (n) 523 (n) Oh 1% 0.99 [0.65-1.50] n/a n/a Son (PSM) 24% 0.76 [0.34-1.71] case control Ma (PSM) 9% 0.91 [0.82-1.02] Chow (PSM) 19% 0.81 [0.76-0.87] 1,280/6,781 2,271/10,566 Kim (PSM) -700% 8.00 [1.07-59.6] 6/15 1/20 Basheer -13% 1.13 [1.05-1.21] 45/140 29/250 Sisinni -7% 1.07 [0.89-1.29] 93/253 251/731 Pérez-Segura -49% 1.49 [1.20-1.80] 66/155 183/608 Sullerot (IPW) -10% 1.10 [0.81-1.49] 101/301 224/746 Monserrat V.. (PSM) -31% 1.31 [1.01-1.71] n/a n/a Gogtay -6% 1.06 [0.51-1.89] 12/38 21/87 Campbell (IPW) 3% 0.97 [0.95-1.00] 419 (n) 20,311 (n) Lal 11% 0.89 [0.82-0.97] 4,691 (n) 16,888 (n) Tau​2 = 0.05, I​2 = 91.6%, p = 0.47 Prophylaxis 5% 0.95 [0.84-1.08] 2,188/20,768 3,905/59,166 5% improvement All studies 13% 0.87 [0.81-0.94] 2,767/32,132 5,142/74,290 13% improvement 39 aspirin COVID-19 mortality results c19aspirin.com May 2022 Tau​2 = 0.03, I​2 = 86.5%, p = 0.00072 Favors aspirin Favors control
Figure 5. Random effects meta-analysis for mortality results.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Goshua (PSM) -49% 1.49 [1.03-2.18] 319 (n) 319 (n) Improvement, RR [CI] Treatment Control Chow 44% 0.56 [0.37-0.85] 35/98 152/314 Abdelwahab -8% 1.08 [0.15-3.82] 11/31 6/36 Kim (PSM) -102% 2.02 [0.83-4.90] 13/124 7/135 RECOVERY (RCT) 5% 0.95 [0.87-1.05] 7,351 (n) 7,541 (n) Tau​2 = 0.12, I​2 = 81.0%, p = 0.94 Late treatment -2% 1.02 [0.70-1.47] 59/7,923 165/8,345 -2% improvement Chow (PSM) 3% 0.97 [0.93-1.02] 2,122/6,781 3,403/10,566 Improvement, RR [CI] Treatment Control Kim (PSM) -433% 5.33 [0.66-43.0] 4/15 1/20 Gogtay 50% 0.50 [0.18-1.22] 5/38 21/87 Tau​2 = 0.23, I​2 = 56.9%, p = 0.88 Prophylaxis 6% 0.94 [0.45-1.95] 2,131/6,834 3,425/10,673 6% improvement All studies 5% 0.95 [0.80-1.12] 2,190/14,757 3,590/19,018 5% improvement 8 aspirin COVID-19 mechanical ventilation results c19aspirin.com May 2022 Tau​2 = 0.02, I​2 = 73.4%, p = 0.54 Favors aspirin Favors control
Figure 6. Random effects meta-analysis for ventilation.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Goshua (PSM) -45% 1.45 [1.06-1.98] 319 (n) 319 (n) Improvement, RR [CI] Treatment Control Chow 43% 0.57 [0.38-0.85] 38/98 160/314 Vahedian-Azimi -10% 1.10 [0.68-1.68] 36/337 44/250 Kim (PSM) -91% 1.91 [0.57-6.35] 7/124 4/135 Tau​2 = 0.25, I​2 = 86.4%, p = 0.87 Late treatment -5% 1.05 [0.60-1.84] 81/878 208/1,018 -5% improvement Kim (PSM) -433% 5.33 [0.66-43.0] 4/15 1/20 Improvement, RR [CI] Treatment Control Sullerot (IPW) -110% 2.10 [1.21-3.64] 22/301 26/746 Gogtay 49% 0.51 [0.06-1.46] 9/38 38/87 Tau​2 = 0.91, I​2 = 85.0%, p = 0.58 Prophylaxis -43% 1.43 [0.41-4.95] 35/354 65/853 -43% improvement All studies -13% 1.13 [0.70-1.83] 116/1,232 273/1,871 -13% improvement 7 aspirin COVID-19 ICU results c19aspirin.com May 2022 Tau​2 = 0.30, I​2 = 83.7%, p = 0.63 Favors aspirin Favors control
Figure 7. Random effects meta-analysis for ICU admission.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Connors (DB RCT) 67% 0.33 [0.01-7.96] hosp. 0/144 1/136 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.5 Early treatment 67% 0.33 [0.01-7.96] 0/144 1/136 67% improvement Ma (PSM) 2% 0.98 [0.92-1.04] hosp. Improvement, RR [CI] Treatment Control Sullerot (IPW) -10% 1.10 [1.01-1.20] hosp. time 301 (n) 746 (n) Nimer 4% 0.96 [0.69-1.33] hosp. 83/427 136/1,721 Tau​2 = 0.00, I​2 = 63.2%, p = 0.63 Prophylaxis -2% 1.02 [0.93-1.12] 83/728 136/2,467 -2% improvement All studies -2% 1.02 [0.94-1.12] 83/872 137/2,603 -2% improvement 4 aspirin COVID-19 hospitalization results c19aspirin.com May 2022 Tau​2 = 0.00, I​2 = 49.3%, p = 0.62 Favors aspirin Favors control
Figure 8. Random effects meta-analysis for hospitalization.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Connors (DB RCT) 19% 0.81 [0.28-2.35] 6/144 7/136 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.71 Early treatment 19% 0.81 [0.28-2.35] 6/144 7/136 19% improvement Husain 96% 0.04 [0.00-0.64] 0/11 17/31 Improvement, RR [CI] Treatment Control Bradbury (RCT) 21% 0.79 [0.65-0.96] 204/563 212/521 Tau​2 = 3.36, I​2 = 77.5%, p = 0.34 Late treatment 75% 0.25 [0.02-4.19] 204/574 229/552 75% improvement Son (PSM) -7% 1.07 [0.65-1.75] case control Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.44 Prophylaxis -7% 1.07 [0.65-1.75] -7% improvement All studies 13% 0.87 [0.62-1.21] 210/718 236/688 13% improvement 4 aspirin COVID-19 progression results c19aspirin.com May 2022 Tau​2 = 0.06, I​2 = 74.5%, p = 0.41 Favors aspirin Favors control
Figure 9. Random effects meta-analysis for progression.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Husain 65% 0.35 [0.05-2.51] no recov. 1/11 8/31 Improvement, RR [CI] Treatment Control RECOVERY (RCT) 6% 0.94 [0.91-0.98] no disch. 7,351 (n) 7,541 (n) Bradbury (RCT) 17% 0.83 [0.67-1.02] no disch. 161/563 167/521 Tau​2 = 0.00, I​2 = 27.6%, p = 0.087 Late treatment 9% 0.91 [0.82-1.01] 162/7,925 175/8,093 9% improvement All studies 9% 0.91 [0.82-1.01] 162/7,925 175/8,093 9% improvement 3 aspirin COVID-19 recovery results c19aspirin.com May 2022 Tau​2 = 0.00, I​2 = 27.6%, p = 0.087 Favors aspirin Favors control
Figure 10. Random effects meta-analysis for recovery.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huh 71% 0.29 [0.14-0.58] cases population-based cohort Improvement, RR [CI] Treatment Control Merzon 28% 0.72 [0.53-0.99] cases 73/1,621 589/8,856 Oh 12% 0.88 [0.79-0.99] cases n/a n/a Son (PSM) -11% 1.11 [0.94-1.30] cases case control Ma (PSM) -9% 1.09 [0.96-1.25] symp. case