Association of mortality and aspirin prescription for COVID-19 patients at the Veterans Health Administration

• DOI: 10.1371/journal.pone.0246825
• Publication Date: 2021-02-12T00:02:01Z
• Authors: Thomas F. Osborne; Zachary P. Veigulis; David M. Arreola; Satish M. Mahajan; Eliane Röösli; Catherine M. Curtin
• Keywords: Adult; Male; Science; Veterans Health; 03 medical and health sciences; 0302 clinical medicine; Humans; Propensity Score; Aged; Retrospective Studies; Aspirin; SARS-CoV-2; Q; Anti-Inflammatory Agents, Non-Steroidal; R; COVID-19; Middle Aged; Protective Factors; COVID-19 Drug Treatment; 3. Good health; Medicine; Female; Platelet Aggregation Inhibitors; Research Article

There is growing evidence that thrombotic and inflammatory pathways contribute to the severity of COVID-19. Common medications such as aspirin, that mitigate these pathways, may decrease COVID-19 mortality. This retrospective assessment was designed to quantify the correlation between pre-diagnosis aspirin and mortality for COVID-19 positive patients in our care. Data from the Veterans Health Administration national electronic health record database was utilized for the evaluation. Veterans from across the country with a first positive COVID-19 polymerase chain reaction lab result were included in the evaluation which comprised 35,370 patients from March 2, 2020 to September 13, 2020 for the 14-day mortality cohort and 32,836 patients from March 2, 2020 to August 28, 2020 for the 30-day mortality cohort. Patients were matched via propensity scores and the odds of mortality were then compared. Among COVID-19 positive Veterans, preexisting aspirin prescription was associated with a statistically and clinically significant decrease in overall mortality at 14-days (OR 0.38, 95% CI 0.32–0.46) and at 30-days (OR 0.38, 95% CI 0.33–0.45), cutting the odds of mortality by more than half. Findings demonstrated that pre-diagnosis aspirin prescription was strongly associated with decreased mortality rates for Veterans diagnosed with COVID-19. Prospective evaluation is required to more completely assess this correlation and its implications for patient care.