NSAIDs unrelated to more serious coronavirus disease, findings

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac is not associated with adverse effects in people tested positive for COVID-19, according to a new study published on September 8. When PLOS medicine By Anton Pottegård of the University of Southern Denmark and colleagues at Aarhus University Hospital and the Danish Medicines Agency.

Early in the COVID-19 pandemic, concerns were raised that the use of the analgesic ibuprofen could lead to a more severe course of coronavirus disease. Given the widespread use of ibuprofen and other NSAIDs, data on their safety are urgently needed to guide clinicians and patients. In the new study, researchers obtained data on all 9,326 Danish residents who were positive for the SARS-CoV-2 virus between February 27, 2020 and April 29, 2020. Data on NSAID use, 30-day mortality, hospitalization, ICU were available for hospitalization, mechanical ventilation, and acute renal replacement therapy. Within 30 days of a positive virus test, 248 (2.7%) completed an NSAID prescription.

The researchers found no association between results and NSAID use. 6.3% (95% confidence interval) among NSAID users in the matched cohort who were positive for coronavirus [CI] 3.1-9.4) Death, 24.5% (95% CI 18.6-30.4) hospitalized, 4.9% (95% CI 2.1-7.8) hospitalized in ICU. Of those who were coronavirus positive and not treated with NSAIDs, 6.1% (95% CI 4.4-7.8) died, 21.2% (95% CI 18.1-24.3) were hospitalized, 4.7% (95% CI 3.2-6.2). I was admitted to the ICU. Differences between these groups were not statistically significant (mortality risk ratio [RR] 1.02, 95% CI 0.57–1.82, p = 0.95; admission RR 1.16, 95% CI 0.87–1.53, p = 0.31; ICU admission RR 1.04, 95% CI 0.54 to 2.02, p = 0.90).

“Given the available evidence, there is no reason to discontinue the well-documented use of NSAIDs during a pandemic of SARS-CoV-2,” the authors write. “However, the established side effects of NSAIDs, especially the renal, gastrointestinal, and cardiovascular effects, should always be considered, and NSAIDs should be used for all patients in the shortest possible time, at the lowest possible dose. Should be used in.”

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Refereed; Experimental Study; Human

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Funding: The author did not receive any particular funding for this work.

Competing Stakeholders: I have read the journal’s policy and the authors of this manuscript have the following competing interests: KBK, NBJ, SC, NB, no conflicts of interest declared. Although the RWT and CFC have not declared a personal conflict of interest, the Department of Clinical Epidemiology is involved in research funded by various companies through research grants and administration to Aarhus University. None of these studies are related to current studies. HS will report personal fees from Bristol-Myers Squibb, personal fees from Novartis, and personal fees from Roche other than the submitted work. AP and JH report their participation in research funded by Archon, Almir, Astellas, AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Servier and LEO Pharma. Studies reported in this paper. LCL reports participation in a research project funded by Menarini Pharmaceuticals and LEO Pharma. MR reports participation in a research project funded by LEO Pharma. The funds were paid to the institution where she was hired (no personal fees) and are unrelated to the study reported in this paper.

Source: Lund LC, Kristensen KB, Reilev M, Christensen S, Thomsen RW, Christiansen CF, etc. (2020) Adverse outcomes and mortality among nonsteroidal anti-inflammatory drug users tested for SARS-CoV-2 positives. : Danish National Cohort Study. PLoS Med 17 (9): e1003308. https://Doi.org/Ten.1371 /journal.pmed.1003308

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