No association of low‐dose aspirin with severe COVID‐19 in France: A cohort of 31.1 million people without cardiovascular disease

BACKGROUND: Aspirin at low doses has been reported to be a potential drug candidate to treat or prevent severe coronavirus disease 2019 (COVID‐19). OBJECTIVES: We aimed to explore whether low‐dose aspirin used for primary cardiovascular prevention was associated with a lower risk of severe COVID‐19. METHOD: A large cohort of patients without known cardiovascular comorbidities was constructed from the entire French population registered in national health care databases. In total, 31.1 million patients aged ≥40 years, including 1.5 million reimbursed for low‐dose aspirin at least at three time points during the 6 months before the epidemic, were followed until hospitalization with a COVID‐19 diagnosis or intubation/death for hospitalized patients. RESULTS: Cox models adjusted for age and sex showed a positive association between low‐dose aspirin and the risk of hospitalization (hazard ratio [HR], 1.33; 95% confidence interval (CI), 1.29‐1.37]) or death/intubation (HR, 1.40 [95% CI, 1.33‐1.47]). In fully adjusted models, associations were close to null (HR, 1.03 [95% CI, 1.00‐1.06] and 1.04 [95% CI, 0.98‐1.10], respectively). CONCLUSION: There was no evidence for an effect of low‐dose aspirin for primary cardiovascular prevention in reducing severe COVID‐19.