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New guidance on daily aspirin isn’t connected to COVID-19

October 14, 2021 GMT

CLAIM: Aspirin was found to be helpful against COVID-19. Now Aspirin is being attacked.

AP’S ASSESSMENT: Missing context. New draft guidance from a federal panel concerns whether adults over 40 should take aspirin daily to prevent having a first heart attack or stroke. It is unrelated to COVID-19. Scientists are still researching whether aspirin may benefit some COVID-19 patients.

THE FACTS: A federal health guidelines group announced on Tuesday a preliminary update to its advice concerning the use of daily low-dose aspirin to prevent a first heart attack or stroke.

As The Associated Press reported, the draft guidance from the U.S. Preventive Services Task Force says that for adults in their 60s and older who haven’t previously had a heart attack or stroke, bleeding risks from aspirin outweigh any potential benefits from taking it daily.

The task force said there may be a small benefit for adults in their 40s who do not have a bleeding risk. For those in their 50s, the group softened its previous advice and said evidence of a benefit is less clear.

But the announcement — a departure from previous guidance the task force issued in 2016 — was baselessly cast in some social media and blog posts as a move against aspirin because of beliefs that the drug could help with COVID-19.

“Studies Suggested Aspirin Lowers COVID Mortality Rates, Now the Powers That Be Are Attacking It,” a headline on the blog RedState.com reads.

The article states: “While there’s no hard paper trail that’s surfaced as of yet, this sudden attack on aspirin follows a pattern of medications being attacked after they were discovered (or at least generated strong evidence) to be effective against COVID-19.”

But the draft guidance is unrelated to COVID-19. The blog’s author at RedState did not immediately respond to a request to comment.

“We did not look at aspirin effects on COVID — to either start it or stop it,” Dr. John Wong, a member of the task force and primary-care expert at Tufts Medical Center, said in a phone interview.

In fact, a draft research plan was posted in January 2020, indicating that work on the reassessment was long in the works. The task force is an independent group of disease-prevention experts.

Wong said the primary purpose of the review was to determine whether someone should initiate taking daily aspirin to prevent a first stroke or heart attack. The task force ultimately found that the age of a person, their risk of heart disease and their risk of bleeding should all be considered. The group also reviewed evidence regarding aspirin in preventing colorectal cancer and determined that more research is needed.

Dr. Mark Ebell, a professor of epidemiology at the University of Georgia and a former member of the task force, said the new guidance incorporates the findings of newer studies. It also brings the task force’s recommendations closer in line with what other groups advise, he said — such as a 2019 joint recommendation by the American College of Cardiology and American Heart Association.

Importantly, the new draft guidance regarding aspirin does not change doctors’ recommendations of daily low-dose aspirin for patients who have already had a heart attack or stroke.

The relationship between aspirin and COVID-19 outcomes is still being assessed.

Dr. Jonathan Chow, a George Washington University associate professor of anesthesiology and critical care medicine, conducted an observational study that suggested COVID-19 patients who were already on blood thinners, such as aspirin, before hospitalization may experience lower mortality risk. Though, Chow said, randomized controlled trials provide the best form of evidence.

One clinical trial didn’t find giving aspirin or blood thinners to outpatients with COVID-19 to be helpful at reducing major adverse cardiovascular and lung issues. Another study done by researchers in the United Kingdom, which has not been peer-reviewed, noted some slight potential benefits of aspirin but found that overall it did not reduce mortality among hospitalized COVID-19 patients within 28 days.

Chow said the task force’s announcement Tuesday “is completely independent of any study related to COVID-19.” He noted that researchers investigating aspirin in relation to COVID-19 were already aware of the data underpinning the new draft guidance relating to heart attack and stroke prevention.

There are indeed known risks associated with aspirin, such as bleeding, that need to be assessed against the benefits, Chow said.

He said the takeaway message is that “before people go to the pharmacy and just start taking an aspirin a day” they should “consult their primary care physician first.”

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This is part of AP’s effort to address widely shared misinformation, including work with outside companies and organizations to add factual context to misleading content that is circulating online. Learn more about fact-checking at AP.