Aspirin Not Beneficial in Hospitalised COVID-19 Patients, Finds RECOVERY Trial

Pavankumar Kamat

Disclosures

November 23, 2021

Takeaway

  • Aspirin plus usual care vs usual care alone had no significant effect on all-cause mortality and the risk of progressing to invasive mechanical ventilation or death among patients hospitalised with SARS-CoV-2 infection.

  • A small significant increase was observed in the rate of being discharged alive within 28 days with aspirin vs usual care only.

Why this matters

  • Findings do not support the use of aspirin with standard thromboprophylaxis or therapeutic anticoagulation in hospitalised patients with COVID-19.

Study details

  • The RECOVERY trial randomly assigned 14,892 hospitalised patients (from 167 UK hospitals and 2 hospitals each in Nepal and Indonesia) with suspected or laboratory-confirmed SARS-CoV-2 infection to receive usual care with (n=7351) or without (n=7541) aspirin.

  • Primary outcome: all-cause mortality at 28 days.

  • Funding: UK Research and Innovation (Medical Research Council), National Institute of Health Research and Wellcome Trust.

Key results

  • The rate of all-cause mortality at 28 days was similar between aspirin+usual care and usual care groups (17% vs 17%; rate ratio [RR], 0.96; 95% CI, 0.89-1.04; P=.35).

  • Among patients not on invasive mechanical ventilation at baseline, the proportion of patients progressing to the composite outcome of invasive mechanical ventilation or death was not different between aspirin and usual care groups (21% vs 22%; RR, 0.96; 95% CI, 0.90-1.03; P=.23).

  • A small increase in the rate of being discharged alive from the hospital within 28 days was observed in aspirin vs usual care groups (75% vs 74%; RR, 1.06; 95% CI, 1.02-1.10; P=.0062).

Limitations

  • Open-label trial.

  • Radiological or physiological outcomes were not collected.

 

Disclaimer

RECOVERY Collaborative Group. Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021 Nov 17 [Epub ahead of print]. doi: 10.1016/S0140-6736(21)01825-0. PMID: 34800427 download_resource.label.link 

    This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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