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"I think I’m going to start taking aspirin"

In the UK there is a large, ongoing clinical trial called 'RECOVER' to test different COVID treaments for hospitalised COVID patients. One of the trials included giving hospitalised patients aspirin. The trial was not looking at the treatment of long-covid symptoms (at least not directly in hospital patients).

"A total of 7351 patients were randomised to aspirin 150 mg once daily and compared with 7541 patients randomised to usual care alone. There was no evidence that aspirin treatment reduced mortality."

Link: RECOVERY trial finds aspirin does not improve survival for patients hospitalised with COVID-19: https://www.recoverytrial.net/news/recovery-trial-finds-aspi...

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It feels to me that the medical community at large looks almost exclusively at data regarding severe cases. I'm certainly no medical expert but it seems reasonable to me that the treatments for someone who is literally dying from COVID could be completely orthogonal from those who are in the early stages of the infection. My understanding of severe cases is that the body is no longer or not only fighting the virus but also it's own immune response amongst other things (e.g. blood clotting). And that outcomes are mostly determined by how well the individual is able to weather the storm of their own immune system attacking them. I would not expect aspirin or similar treatments to have much effect when the patient has gotten to this point. Thought certainly, there could be some treatments that help which would prevent this from happening in the first place.

And, I'm aware of the research (and money) being poured into antivirals. Of course that's a thing. I'm sure there are billions if not trillions to be made off a pill you "simply take daily" to prevent the "severe and long covid." The headlines write themselves. But I seriously wonder what research is being done on "mild" covid cases using more cheap/traditional medicines. I know where I live, the doctors don't even talk to you unless your case gets severe - basically once you need oxygen supplementation. Prior to that, you're told to stay home and rest. I'm not even sure they create a record in their medical system.

>> It feels to me that the medical community at large looks almost exclusively at data regarding severe cases. I'm certainly no medical expert but it seems reasonable to me that the treatments for someone who is literally dying from COVID could be completely orthogonal from those who are in the early stages of the infection.

This seems to be a problem with every account of "treatment X doesn't work". They wait until someone is half dead, use X, patient dies at same rate as without X, conclude X is worthless. "preventive" or "protective" are different words than "curative" and that seems to get overlooked in a lot of cases.

Doctor A: When I see someone with Covid Symptoms I give XYZ and they never end up in the hospital.

ER Doctor: We've tried X,Y, and Z in every combination with patients on ventilators and none of that saves them with any statistical significance.

They can both be correct.

Obviously the medical community is aware of this.

Take for example the very recent approval of Molnupiravir:

https://www.bbc.co.uk/news/health-59163899

https://www.nejm.org/doi/full/10.1056/NEJMoa2116044

We conducted a phase 3, double-blind, randomized, placebo-controlled trial to evaluate the efficacy and safety of treatment with molnupiravir started within 5 days after the onset of signs or symptoms in nonhospitalized, unvaccinated adults with mild-to-moderate, laboratory-confirmed Covid-19 and at least one risk factor for severe Covid-19 illness.

The challenge is that you don’t necessary want to be often taking lots of drugs “just in case,” since they can have their own long-term issues (just browse the other comments here for discussion).

Also, adverse-drug interactions is potentially a a major killer already in the US, sometimes from doctors making mistakes, and often from people using OTC drugs outside of their safe regime.

So then, we might wait until it is clear that intervention is necessary, but now the intervention also probably needs to be much more aggressive.

And besides, we do have a pretty good preventative/protective option already in vaccines. It is only when breakthrough cases lead to hospitalization that we then need to pull out the backup strategies, otherwise, we’ve seen that statistically our primed immune systems are usually pretty good at dealing with it on their own.

This doesn't feel super applicable. The body in the middle of a COVID infection vs months later is in a VERY different state. Also I don't even know if there's any mortality data for long COVID; it could just provide quality of life degradation.

I saw an observational study tracking hospitalized (but nominally surviving) Covid patients for a year where a far higher number died (of various causes) than the base rate in the population [sorry I can’t find a link now in a few minutes of searching]. Some of this is selection bias (people who get bad Covid cases tend to be in worse shape to begin with), but I would expect the after-effects of Covid to cause significantly increased mortality. We’ll have much better data about this in a few years.

Thank you for the study.

I’m not worried about mortality so much as getting over the strange long effects I’m feeling. I see this study as well.

https://www.webmd.com/lung/news/20210315/low-dose-aspirin-ma...

> But Magen's group found that people who'd already been taking low-dose aspirin to reduce their risk of heart disease had a 29% lower risk of contracting COVID-19 compared to those who didn't take aspirin, and that rates of aspirin use were much lower among COVID-19 patients than among those who didn't get infected.

>Among people who did get COVID-19, the time it took for SARS-CoV-2 PCR test results to go from positive to negative was significantly shorter among those who used aspirin, and the duration of their disease was two-three days shorter, depending upon preexisting health conditions.

He's not talking about using aspirin as a treatment for when you are hospitalised due to covid.

>> RECOVERY trial finds aspirin does not improve survival for patients hospitalised with COVID-19

How is survival defined? Do they mean "gets released from hospital vs. dies in hospital"? Because it seems a lot of things that can reduce severity of Covid (including vitamin D for example) don't change much at the last minute when you're at deaths door.

In this case, we're talking about long Covid symptoms so it would seem a reduction in 1-year mortality should be the deciding factor (since Severe Covid patients who "survive" still have significantly increase mortality over the next year).

If aspirin doesn't improve survival, does that mean it also will not help with COVID symptoms?

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