By Pat Anson, PNN Editor

Ever since the start of the pandemic, there has been a lively and sometimes heated debate over anti-viral medications like hydroxychloroquine and remdesivir – and whether they can treat or even prevent COVID-19 infections.  

It turns out one of the most effective drugs is a simple and inexpensive pain reliever that most people already have in their medicine cabinets: aspirin.

A new study by researchers at the University of Maryland School of Medicine found that hospitalized COVID-19 patients who took a daily low-dose aspirin had significantly lower risk of complications and death. Aspirin takers were less likely to be placed in an intensive care unit (ICU) or be hooked up to a mechanical ventilator, and they were much more likely to make it out of the hospital alive.

"This is a critical finding that needs to be confirmed through a randomized clinical trial," said study leader Jonathan Chow, MD, Assistant Professor of Anesthesiology at UMSOM. "If our finding is confirmed, it would make aspirin the first widely available, over-the-counter medication to reduce mortality in COVID-19 patients."

Chow and his colleagues say their study, published in the journal Anesthesia and Analgesia, provides "cautious optimism" that a daily low-dose aspirin (usually 81 milligrams) can help prevent severe COVID-19 complications.

Millions of older adults already take aspirin daily to lower their risk of heart attack or stroke.

Researchers analyzed the medical records of 412 COVID-19 patients, aged 55 on average, who were hospitalized at the University of Maryland Medical Center in Baltimore and three other hospitals on the East Coast. About a quarter of the patients were taking a daily low-dose aspirin before they were admitted or right after admission to manage their cardiovascular disease.

Researchers found aspirin reduced the risk of being put on a ventilator by 44 percent, lowered the risk of being put in ICU by 43 percent, and reduced the risk of dying in the hospital by 47 percent.  Patients who took aspirin daily also had less risk of adverse events such as major bleeding.

COVID-19 infections increase the risk of blood clots that can form in the heart, lungs, blood vessels and other organs. Complications from blood clots can lead to heart attacks, strokes, organ failure and death.

"We believe that the blood thinning effects of aspirin provides benefits for COVID-19 patients by preventing microclot formation," said co-author Michael Mazzeffi, MD, Associate Professor of Anesthesiology at UMSOM. "Patients diagnosed with COVID-19 may want to consider taking a daily aspirin as long as they check with their doctor first."

Doctors often recommend a daily “baby” aspirin for patients who have cardiovascular disease. They caution, however, that aspirin can increase the risk of bleeding when taken in combination with other medications like steroids or blood thinners.

"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," said E. Albert Reece, MD, Dean of the University of Maryland School of Medicine.

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 the study.