The use of aspirin for primary prevention of cardiovascular disease is associated with a lower likelihood of COVID-19 infection.

Acetylsalicylic acid (aspirin) is commonly used for primary and secondary prevention of cardiovascular diseases. Aspirin use is associated with better outcomes among COVID-19 positive patients. We hypothesized that aspirin use for primary cardiovascular disease prevention might have a protective effect on COVID-19 susceptibility and disease duration. We conducted a retrospective population-based cross-sectional study, utilizing data from the Leumit Health Services database. The proportion of patients treated with aspirin was significantly lower among the COVID-19-positive group, as compared to the COVID-19-negative group (73 (11.03 %) vs. 1548 (15.77%); p=0.001). Aspirin use was associated with lower likelihood of COVID-19 infection, as compared to non-users (adjusted OR 0.71 (95% CI, 0.52 to 0.99; p=0.041). Aspirin users were older (68.06 ± 12.79 vs. 56.63 ± 12.28 years of age; p<0.001), presented a lower BMI (28.77±5.4 vs. 30.37±4.55; p<0.0189) and showed higher prevalence of hypertension (56, 76.71%), diabetes (47, 64.38%) and COPD (11, 15.07%) than showed the aspirin non-users (151, 25.64%, p<0.001; 130, 22.07%, p<0.001; and 43, 7.3%, p=0.023, respectively). Moreover, COVID-19 disease duration (considered as the time between the first positive and second negative COVID-19 RT-PCR test results) among aspirin users was significantly shorter, as compared to aspirin non-users (19.8±7.8 vs. 21.9± 7.9 p= 0.045). Among hospitalized COVID-positive patients, a higher proportion of surviving subjects were treated with aspirin (20, 19.05%), as opposed to 1 dead subject (14.29%), although this difference was not significant (p=0.449). In conclusion, we observed inverse association between the likelihood of COVID-19 infection, disease duration and mortality and aspirin use for primary prevention.