tetano
Editor, Senior Moderator
J Clin Med
. 2020 Aug 10;9(8):E2586.
doi: 10.3390/jcm9082586.
Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19
Eilidh Bruce[SUP] 1 2 [/SUP], Fenella Barlow-Pay[SUP] 3 [/SUP], Roxanna Short[SUP] 4 [/SUP], Arturo Vilches-Moraga[SUP] 5 [/SUP], Angeline Price[SUP] 5 [/SUP], Aine McGovern[SUP] 6 [/SUP], Philip Braude[SUP] 7 [/SUP], Michael J Stechman[SUP] 8 [/SUP], Susan Moug[SUP] 3 [/SUP], Kathryn McCarthy[SUP] 7 [/SUP], Jonathan Hewitt[SUP] 8 [/SUP], Ben Carter[SUP] 4 [/SUP], Phyo Kyaw Myint[SUP] 1 2 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) infection causes acute lung injury, resulting from aggressive inflammation initiated by viral replication. There has been much speculation about the potential role of non-steroidal inflammatory drugs (NSAIDs), which increase the expression of angiotensin-converting enzyme 2 (ACE2), a binding target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter the host cell, which could lead to poorer outcomes in COVID-19 disease. The aim of this study was to examine the association between routine use of NSAIDs and outcomes in hospitalised patients with COVID-19. This was a multicentre, observational study, with data collected from adult patients with COVID-19 admitted to eight UK hospitals. Of 1222 patients eligible to be included, 54 (4.4%) were routinely prescribed NSAIDs prior to admission. Univariate results suggested a modest protective effect from the use of NSAIDs, but in the multivariable analysis, there was no association between prior NSAID use and time to mortality (adjusted HR (aHR) = 0.89, 95% CI 0.52-1.53, p = 0.67) or length of stay (aHR 0.89, 95% CI 0.59-1.35, p = 0.58). This study found no evidence that routine NSAID use was associated with higher COVID-19 mortality in hospitalised patients; therefore, patients should be advised to continue taking these medications until further evidence emerges. Our findings suggest that NSAID use might confer a modest benefit with regard to survival. However, as this finding was underpowered, further research is required.
Keywords: NSAIDs; SARS-CoV-2; covid-19; non-steroidal anti-inflammatory drugs.
. 2020 Aug 10;9(8):E2586.
doi: 10.3390/jcm9082586.
Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19
Eilidh Bruce[SUP] 1 2 [/SUP], Fenella Barlow-Pay[SUP] 3 [/SUP], Roxanna Short[SUP] 4 [/SUP], Arturo Vilches-Moraga[SUP] 5 [/SUP], Angeline Price[SUP] 5 [/SUP], Aine McGovern[SUP] 6 [/SUP], Philip Braude[SUP] 7 [/SUP], Michael J Stechman[SUP] 8 [/SUP], Susan Moug[SUP] 3 [/SUP], Kathryn McCarthy[SUP] 7 [/SUP], Jonathan Hewitt[SUP] 8 [/SUP], Ben Carter[SUP] 4 [/SUP], Phyo Kyaw Myint[SUP] 1 2 [/SUP]
Affiliations
- PMID: 32785086
- DOI: 10.3390/jcm9082586
Abstract
Coronavirus disease 2019 (COVID-19) infection causes acute lung injury, resulting from aggressive inflammation initiated by viral replication. There has been much speculation about the potential role of non-steroidal inflammatory drugs (NSAIDs), which increase the expression of angiotensin-converting enzyme 2 (ACE2), a binding target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter the host cell, which could lead to poorer outcomes in COVID-19 disease. The aim of this study was to examine the association between routine use of NSAIDs and outcomes in hospitalised patients with COVID-19. This was a multicentre, observational study, with data collected from adult patients with COVID-19 admitted to eight UK hospitals. Of 1222 patients eligible to be included, 54 (4.4%) were routinely prescribed NSAIDs prior to admission. Univariate results suggested a modest protective effect from the use of NSAIDs, but in the multivariable analysis, there was no association between prior NSAID use and time to mortality (adjusted HR (aHR) = 0.89, 95% CI 0.52-1.53, p = 0.67) or length of stay (aHR 0.89, 95% CI 0.59-1.35, p = 0.58). This study found no evidence that routine NSAID use was associated with higher COVID-19 mortality in hospitalised patients; therefore, patients should be advised to continue taking these medications until further evidence emerges. Our findings suggest that NSAID use might confer a modest benefit with regard to survival. However, as this finding was underpowered, further research is required.
Keywords: NSAIDs; SARS-CoV-2; covid-19; non-steroidal anti-inflammatory drugs.