Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19.
Eilidh BruceFenella Barlow-PayRoxanna ShortArturo Vilches-MoragaAngeline PriceAine McGovernPhilip BraudeMichael J StechmanSusan J MougKathryn McCarthyJonathan HewittBen CarterPhyo Kyaw MyintPublished in: Journal of clinical medicine (2020)
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.
Keyphrases
- sars cov
- anti inflammatory drugs
- coronavirus disease
- respiratory syndrome coronavirus
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- angiotensin converting enzyme
- stem cells
- prognostic factors
- type diabetes
- clinical trial
- healthcare
- randomized controlled trial
- peritoneal dialysis
- clinical practice
- cardiovascular events
- cross sectional
- skeletal muscle
- machine learning
- angiotensin ii
- metabolic syndrome
- cardiovascular disease
- patient reported outcomes
- patient reported
- bone marrow
- young adults
- cell therapy
- deep learning
- mesenchymal stem cells
- weight loss
- dna binding