RECOVERY (aspirin)
Trial question
What is the role of aspirin in hospitalized patients with COVID-19?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
38.0% female
62.0% male
N = 14892
14892 patients (5691 female, 9201 male).
Inclusion criteria: adult patients hospitalized with COVID-19.
Key exclusion criteria: age < 18 years; hypersensitivity to aspirin; a recent history of major bleeding; receipt of aspirin; antiplatelet treatment.
Interventions
N=7351 aspirin (usual standard of care plus 150 mg aspirin daily until discharge).
N=7541 usual care (usual standard of care alone).
Primary outcome
Death at day 28
17%
17%
17.0 %
12.8 %
8.5 %
4.3 %
0.0 %
Aspirin
Usual
care
No significant
difference ↔
No significant difference in death at day 28 (17% vs. 17%; RR 0.96, 96% CI 0.89 to 1.04).
Secondary outcomes
Significant increase in alive discharges from the hospital at day 28 (75% vs. 74%; RR 1.06, 95% CI 1.02 to 1.1).
No significant difference in invasive mechanical ventilation or death (21% vs. 22%; RR 0.96, 96% CI 0.9 to 1.03).
No significant difference in invasive mechanical ventilation (11% vs. 12%; RR 0.95, 95% CI 0.87 to 1.05).
Safety outcomes
No significant differences in thrombotic events, new cardiac arrhythmias.
Significant difference in major bleeding (1.6% vs. 1.0%).
Conclusion
In adult patients hospitalized with COVID-19, aspirin was not superior to usual care with respect to death at day 28.
Reference
RECOVERY Collaborative Group. Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2022 Jan 8;399(10320):143-151.
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