The Effect of Aspirin on the Prevention of Pro-thrombotic States in Hospitalized COVID-19 Patients: Systematic Review

Cardiovasc Hematol Agents Med Chem. 2022;20(3):189-196. doi: 10.2174/1871525720666220401102728.


Introduction: Thromboembolic events are one of the important complications in COVID-19 patients, especially in severe cases. Aspirin affects platelet function by irreversibly inhibiting cyclooxygenase activity, reducing the risk of thrombosis. The current systematic review aimed to evaluate aspirin's effectiveness in preventing pro-thrombotic states in COVID-19 hospitalized patients.

Methods: The systematic search was done in PubMed/Medline, EMBASE, and Medrxiv until September 27, 2021. The following keywords were used: "COVID-19", "SARS-CoV-2", "2019 Novel Coronavirus", "Aspirin," and "Acetylsalicylic Acid."

Results: Twelve studies were included. In COVID-19 patients, aspirin can reduce CRP, IL-6 levels, and platelet aggregation by inhibiting thromboxane A2. It can also improve antiviral immunity by hindering the biosynthesis of prostaglandins and lipoxin. Eight out of twelve articles indicated that aspirin provided a beneficial effect on COVID-19. Most studies consider lowered mechanical ventilation needs, ICU admission, illness severity, overt thrombosis, and clinical outcomes in COVID-19 patients receiving aspirin.

Conclusion: Aspirin as an antiplatelet and anti-inflammatory agent may reduce the mortality rates in hospitalized patients with severe COVID-19. Further observational studies are necessary to determine the effect of aspirin on the prevention of pro-thrombotic states in hospitalized COVID- 19 patients.

Keywords: Aspirin; COVID-19; SARS-COV-2; acetylsalicylic acid; pro-thrombotic; thrombosis.

Publication types

  • Systematic Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Aspirin / therapeutic use
  • COVID-19 Drug Treatment*
  • Humans
  • Interleukin-6
  • Lipoxins*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prostaglandin-Endoperoxide Synthases
  • Prostaglandins
  • SARS-CoV-2
  • Thrombosis* / drug therapy
  • Thrombosis* / prevention & control
  • Thromboxane A2


  • Antiviral Agents
  • Interleukin-6
  • Lipoxins
  • Platelet Aggregation Inhibitors
  • Prostaglandins
  • Thromboxane A2
  • Prostaglandin-Endoperoxide Synthases
  • Aspirin