What Is Aspirin?
Aspirin is a widely used over-the-counter medication that acts as an antiplatelet agent, helping to prevent the formation of blood clots. In the context of Long COVID, aspirin is being studied for its potential to address lingering vascular issues, inflammation, and microclot formation—factors believed to contribute to ongoing symptoms.
How Aspirin may Help for Long COVID
- Reducing microclots – Many Long COVID patients have been found to carry persistent fibrin amyloid microclots, which may impair circulation and oxygen delivery. Aspirin may help break down or prevent the formation of these microclots by reducing platelet activation.
- Improving blood flow and oxygenation – By lowering platelet aggregation, aspirin may improve tissue oxygenation and reduce symptoms like fatigue, brain fog, and shortness of breath.
- Calming vascular inflammation – COVID-19 and Long COVID can cause inflammation of the blood vessels. Aspirin’s anti-inflammatory effects may support vascular healing and improved circulation.
What the Research Says
Several clinical studies have investigated the use of aspirin and other anticoagulants in Long COVID. Overall, they found encouraging results, including reduced risk of blood clots, improved symptoms like fatigue and shortness of breath, and evidence of reduced microclot burden. These findings suggest that anticoagulants may help address one of the underlying drivers of Long COVID in select patients.
Key literature on Aspirin and Long COVID
Studies showing positive effects:
- This study analyzed data from over 330,000 U.S. Veterans and found that preexisting aspirin use was associated with a significantly lower risk of blood clots in the veins after COVID.
- This preprint study examined 70 Long COVID patients and treated 24 with a one-month triple therapy: aspirin + clopidogrel (DAPT), apixaban (DOAC), and pantoprazole (PPI). All 24 (100%) reported full resolution of main symptoms like fatigue. Lab results showed a measurable reduction in microclots and platelet pathology scores, with clot burden dropping from a score of 3+ to 0 in many cases.
- This observational study examined medication use in postpartum Long COVID patients. It found that those taking aspirin 325 mg were significantly more likely to report symptom improvement compared to those who didn’t (19.8% vs 11.3%).
Theoretical Support:
- This review outlines the mechanisms behind COVID-related clotting, including immune-thrombotic pathways, platelet activation, and complement system involvement. It proposes that anticoagulants may be beneficial by addressing these interlinked pathways.
- This article argues that early anticoagulation could prevent long-term thrombotic complications in Long COVID. It describes how extracellular vesicles and vascular inflammation contribute to persistent clotting and suggests that prompt antithrombotic therapy may improve long-term outcomes.
Final Thoughts
Aspirin is a low-cost, widely available medication that may offer symptom relief for some Long COVID patients, especially those with evidence of vascular inflammation, microclots, or circulatory issues. While early findings are promising, aspirin is still a blood thinner, and its use should be carefully supervised by a healthcare provider to avoid risks like bleeding. More research is needed to fully understand its role in Long COVID recovery.
