You may have seen quite a bit about risk factors that make a COVID-19 infection more likely or more dangerous. People with kidney disease, heart problems, COPD, an organ transplant, cancer or diabetes could become extremely ill if they contract it. General Colin Powell, for example, had the blood cancer multiple myeloma and was immunocompromised. That made him more vulnerable to COVID even though he was vaccinated. But what about protective factors? This reader wonders, could using aspirin help protect people from catching COVID?
Q. Does low-dose aspirin offer any protection against COVID, especially for older people? My wife is 69 and I am 71. We both are fully vaccinated but have breakthrough cases.
We have been able to manage our care at home. I recall reading many months ago that low-dose aspirin reduces the inflammatory response and therefore might mitigate COVID symptoms. Has there been more definitive research on this?
A. There has been more research. However, as with so much regarding COVID, the answer is complicated.
A study published in the Journal of Thrombosis and Haemostasis (Aug. 29, 2021) tracked more than 17,000 patients 50 or older with COVID. Those who had been taking aspirin before admission were less likely to die. The authors point out that previous studies have also found lower in-hospital mortality among COVID patients already taking aspirin.
Evidence from Israel Stars Aspirin:
A study from Israel suggests that aspirin may provide some protection against COVID-19 infections (FEBS Journal, Feb. 23, 2021). Researchers reviewed data from more than 10,000 individuals tested for the coronavirus. They compared people who were taking 75 mg of aspirin daily for cardiovascular protection with others who were not prescribed aspirin.
The aspirin users were 29 percent less likely to have a positive COVID-19 test. In addition, if they did contract the infection, they seemed to recover two to three days faster. This is especially notable because those on the medication were older, on average. They were also more likely to have high blood pressure, diabetes and chronic obstructive pulmonary disease (COPD). Notably, these are all risk factors for COVID.
More Evidence That Aspirin Helps Protect People from COVID Infection:
Most importantly, some of the individuals in this study required hospitalization. The researchers note that a higher proportion of survivors were on aspirin before they became infected. However, the numbers of hospitalized patients were fairly small. Consequently, the difference was not significant.
The lead author notes that
“This observation of the possible beneficial effect of low doses of aspirin on COVID-19 infection is preliminary but seems very promising.”
Is Aspirin Counterproductive vs. COVID?
On the other hand, a Korean study (Medicina, Sept. 4, 2021) found that:
“Aspirin use was associated with adverse effects in COVID-19 patients”
“In this Korean nationwide cohort, we investigated whether aspirin use decreased susceptibility to COVID-19 among 22,660 patients who underwent COVID-19 testing. We found that aspirin use, both before and after the diagnosis of COVID-19, did not decrease susceptibility to COVID-19 infection. Meanwhile, aspirin use before COVID-19 was related to an increased risk of worsened outcomes, especially death, and aspirin use after COVID-19 was related to an increased rate of conventional oxygen therapy.”
The Moral of the Tale:
There is so much we do not know about preventing and treating COVID-19. Will aspirin help protect you or will it harm you? We need well-conducted clinical trials to learn whether aspirin can help or hurt.
No one should start taking aspirin against COVID without first checking with their health care provider. We certainly do not want to make matters worse!