A new study led by researchers at the University of Maryland School of Medicine (UMSOM) said, hospitalised COVID-19 patients who were taking a daily low-dose aspirin to protect against cardiovascular disease showed a significantly low risk of complications and death compared to those who were not taking aspirin.
Patients who took aspirin were less likely to be placed in the intensive care unit (ICU) or hooked up to a mechanical ventilator and they were more likely to survive the infection compared to hospitalised patients who were not taking aspirin.
The study, published in the journal Anesthesia and Analgesia, suggests “cautious optimism,” the researchers say, for an inexpensive, accessible medication with a well-known safety profile that could help prevent severe complications.
The study leader Jonathan Chow, MD, Assistant Professor of Anesthesiology at UMSOM said, “This is a critical finding that needs to be confirmed through a randomized clinical trial. If our finding is confirmed, it would make aspirin the first widely available, over-the-counter medication to reduce mortality in COVID-19 patients.”
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For conducting the study Dr. Chow and his colleagues gathered the medical records of 412 COVID-19 patients, the age of 55 on average, who were hospitalised over the past few months due to complications of their infection.
They were treated at the University of Maryland Medical Center in Baltimore and three other hospitals along the East Coast. About a quarter of the patients were taking a daily low-dose aspirin (usually 81 milligrams) before they were admitted or right after admission to manage their cardiovascular disease.
As a result, it was found that aspirin use was associated with a 44 percent reduction in the risk of being put on a mechanical ventilator, a 43 percent decrease in the risk of ICU admission, and most importantly there was a decrease in 47 percent decrease in the risk of dying in hospital compared to those who were not taking aspirin.
The patients in the aspirin group did not experience a significant increase in adverse events such as major bleeding while hospitalised. Several factors were controlled by the researchers that may have played a role in a patient’s prognosis including age, gender, body mass index, race, hypertension, and diabetes.
They also worked on heart disease, kidney disease, liver disease, and the use of beta-blockers to control blood pressure.
COVID-19 infection increases the risk of dangerous blood clots that can form in the heart, lungs, blood vessels, and other organs.
In rare cases, these complications from blood clots cause heart attacks, strokes, and multiple organ failure as well as death. Often the doctors recommend daily low-dose aspirin for patients who have had a heart attack or stroke before caused by a blood clot to prevent future blood clots.
However, daily use of aspirin can increase the risk of major bleeding or peptic ulcer disease.
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Study co-author Michael A. Mazzeffi, MD, Associate Professor of Anesthesiology at UMSOM said, “We believe that the blood-thinning effects of aspirin provide benefits for COVID-19 patients by preventing micro clot formation.”
“Patients diagnosed with COVID-19 may want to consider taking a daily aspirin as long as they check with their doctor first,” added Mazzeffi.
Those at increased bleeding risk due to chronic kidney disease, for example, or because they regularly use certain medications, like steroids or blood thinners, may not be able to safely take aspirin, he added.
Researchers from Wake Forest School of Medicine, George Washington University School of Medicine, Northeast Georgia Health System, and Walter Reed National Military Medical Center also participated in this study.
“This study adds to the tremendous work our researchers are doing in the School of Medicine to help find new treatments against COVID-19 and save patients’ lives,” said E. Albert Reece, MD, Ph.D., MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine.
“While confirmatory studies are needed to prove that aspirin use leads to better outcomes in COVID-19, the evidence thus far suggests that patients may want to discuss with their doctor whether it is safe for them to take aspirin to manage potentially prevent serious complications,” added Reece.
