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. 2022 Nov;58(11):746-753.
doi: 10.1016/j.arbres.2022.07.017. Epub 2022 Sep 8.

Pre-hospital Aspirin Use and Patient Outcomes in COVID-19: Results from the International Viral Infection and Respiratory Illness Universal Study (VIRUS)

[Article in English, Spanish]
Amos Lal  1 , Juan Pablo Domecq Garces  2 , Vikas Bansal  3 , Aysun Tekin  3 , Simon Zec  3 , Ashish K Khanna  4 , Matthew A Warner  5 , Amy B Christie  6 , Rodrigo Cartin-Ceba  7 , Valerie M Banner-Goodspeed  8 , Donna Lee Armaignac  9 , Sreekanth R Cheruku  10 , Umamaheswara Raju  11 , Yasir Tarabichi  12 , Joshua L Denson  13 , Vishakha Kumar  14 , Allan Walkey  15 , Karen Boman  14 , Neha Deo  3 , Rahul Kashyap  16 , Ognjen Gajic  3 ; from the Society of Critical Care Medicine Discovery Viral Infection, Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
Affiliations

Pre-hospital Aspirin Use and Patient Outcomes in COVID-19: Results from the International Viral Infection and Respiratory Illness Universal Study (VIRUS)

[Article in English, Spanish]
Amos Lal et al. Arch Bronconeumol. 2022 Nov.

Abstract

Introduction: The goal of this investigation is to assess the association between prehospital use of aspirin (ASA) and patient-centered outcomes in a large global cohort of hospitalized COVID-19 patients.

Methods: This study utilizes data from the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) Registry. Adult patients hospitalized from February 15th, 2020, to September 30th, 2021, were included. Multivariable regression analyses were utilized to assess the association between pre-hospital use of ASA and the primary outcome of overall hospital mortality.

Results: 21,579 patients were included from 185 hospitals (predominantly US-based, 71.3%), with 4691 (21.7%) receiving pre-hospital ASA. Patients receiving ASA, compared to those without pre-admission ASA use, were generally older (median 70 vs. 59 years), more likely to be male (58.7 vs. 56.0%), caucasian (57.4 vs. 51.6%), and more commonly had higher rates of medical comorbidities. In multivariable analyses, patients receiving pre-hospital ASA had lower mortality (HR: 0.89, 95% CI 0.82-0.97, p=0.01) and reduced hazard for progression to severe disease or death (HR: 0.91, 95% CI 0.84-0.99, p=0.02) and more hospital free days (1.00 days, 95% CI 0.66-1.35, p=0.01) compared to those without pre-hospital ASA use. The overall direction and significance of the results remained the same in sensitivity analysis, after adjusting the multivariable model for time since pandemic.

Conclusions: In this large international cohort, pre-hospital use of ASA was associated with a lower hazard for death in hospitalized patients with COVID-19. Randomized controlled trials may be warranted to assess the utility of pre-hospital use of ASA.

Keywords: Aspirin; COVID-19; Length of stay; Mechanical ventilation; Mortality.

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Figures

None
Graphical abstract
Fig. 1
Fig. 1
Consort diagram explaining patient inclusion scheme from the VIRUS registry.
Fig. 2
Fig. 2
Forest plot of adjusted HRs with ASA use. 95% CIs for adjusted ORs are plotted. HR, hazard ratio; ICU, intensive care unit; CVA, cerebrovascular accident; IMV, invasive mechanical ventilation; GI, gastrointestinal; pRBC, packed red blood cells.
See this image and copyright information in PMC

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