MedicalResearch.com Interview with: Michael Mazzeffi MD MPH MSc Associate Professor of Anesthesiology Division Chief Anesthesiology Critical Care Medicine Medical Director Rapid Response Team MedicalResearch.com: What is the background for this study? Response: We have known for some time that COVID19 is characterized by hypercoagulability or excess blood clotting.  In fact, the incidence of blood clots in the lungs (pulmonary emboli) is as high 20% and is two to three times more common in COVID19 than in severe influenza.  Further, autopsies of patients who died from COVID19 have shown that endothelial cells (cells that line the blood vessels) are damaged and that "micro clots" form in multiple organs.  Together, these findings strongly suggest that excess blood clotting and endothelial cell dysfunction are defining features of severe COVID19. For several months, my colleagues and I have been interested in whether aspirin might improve outcomes in patients with severe COVID19.  In prior observational research studies, aspirin was found to be protective in patients with severe lung injury.  The general idea is that aspirin reduces platelet aggregates in the lung and this improves outcome.  Unfortunately, in a prior randomized controlled study (LIPS-A) aspirin was not shown to reduce the incidence of acute respiratory distress syndrome.  Nevertheless, COVID19 has unique features that make aspirin more likely to be effective.  Mainly COVID19 is associated with hypercoagulability to a greater degree than in other viral illnesses.  (more…)