COVID-19 pandemic has increased thrombotic risk by 35%. This pandemic led to millions of deaths due to various comorbidities and organ failure. Repurposing aspirin usage to manage COVID-19 hospitalized patients is a logical approach for preventing cardiovascular disease and comorbidities that increase mortality risk. However, several earlier investigations found inconsistent outcomes. This study aims to assess primary and secondary effects in COVID-19 patients with or without aspirin. We performed a multi-database electronic search including Cochrane, Embase, Scopus, and PubMed from date of inception to November 2021 using search terms: (Coronavirus Disease 2019 OR COVID-19 OR SARS-CoV-2 OR 2019-nCoV) AND (Acetylsalicylic acid OR acetylsalicylate OR aspirin OR antiplatelet) AND (mortality OR severe OR severity). Eight retrospective studies met the study criteria comprising 7,171 aspirin users and 8,327 non-aspirin users in COVID- 19. Aspirin administration significantly reduces mortality risk (RR: 0.51, 95% CI: 0.46-0.57, I2 = 85.05, p-value
Key words: Low dose aspirin, mortality, COVID-19, thrombosis, antiplatelet drug
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