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

• Published in: PloS one 2021-02, Vol.16 (2), p.e0246825-e0246825
• Main Authors: Osborne, Thomas F, Veigulis, Zachary P, Arreola, David M, Mahajan, Satish M, Röösli, Eliane, Curtin, Catherine M
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Aspirin; Aspirin - therapeutic use; Biology and Life Sciences; Comorbidity; Computer and Information Sciences; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - drug therapy; COVID-19 - epidemiology; COVID-19 - mortality; Data analysis; Data warehouses; Demographic aspects; Demographics; Demography; Dosage and administration; Editing; Federal agencies; Female; Health care; Health care access; Health care facilities; Health care policy; Health risks; Heart failure; Humans; Male; Medicine; Medicine and Health Sciences; Methodology; Middle Aged; Morbidity; Mortality; Patient outcomes; Patients; Platelet Aggregation Inhibitors - therapeutic use; Prevention; Propensity Score; Protective Factors; Radiology; Relational data bases; Retrospective Studies; Risk factors; SARS-CoV-2 - drug effects; SARS-CoV-2 - isolation & purification; Surgery; Veterans; Veterans Health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0246825

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.