Prior Routine use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19

Eilidh Bruce, Fenella Barlow-Pay, Roxanna Short, Arturo Vilches-Moraga, Angeline Price, Aine McGovern, Philip Braude, Michael J. Stechman, Susan Moug, Kathryn McCarthy, Jonathan Hewitt, Ben Carter, Phyo Kyaw Myint* (Corresponding Author)

*Corresponding author for this work

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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
Original languageEnglish
Article number 2586
Number of pages13
JournalJournal of Clinical Medicine
Volume9
Issue number8
DOIs
Publication statusPublished - 10 Aug 2020

Keywords

  • covid-19
  • SARS-CoV-2
  • non-steroidal anti-inflammatory drugs
  • NSAIDs

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