Horby PW, Pessoa-Amorim G, Staplin N, et al. - Use of aspirin in the treatment of hospitalized COVID-19 cases did not confer decreases in 28 day mortality or in the risk of progressing to invasive mechanical ventilation or death, but resulted in a small increase in the rate of being discharged alive within 28 days.

• A randomized, controlled, open-label, platform trial in which patients hospitalized with COVID-19 were randomized to either usual standard of care plus 150 mg aspirin once per day until discharge (n=7,351) or usual standard of care alone (n=7,541).

• In the aspirin and usual care groups, death within 28 days occurred in 1,222 (17%) and 1,299 (17%) patients, respectively (rate ratio 0·96, 95% CI 0·89–1·04; p=0·35).

• In the aspirin group, there was a slightly shorter span of hospitalization (median 8 days vs 9 days) and a higher proportion of patients were discharged from hospital alive within 28 days (75% vs 74%; rate ratio 1·06).

• Treatment with aspirin conferred decrease in thrombotic events (4·6% vs 5·3%; absolute decrease 0·6%) but was linked with increase in major bleeding events (1·6% vs 1·0%; absolute increase 0·6%).