Use of NSAIDs is Associated with Worse Outcomes Among Hospitalized COVID-19 Patients | Virus World | Scoop.it
From www.medrxiv.org - June 17, 2020 2:46 PM

Non-steroidal anti-inflammatory drugs (NSAIDs) may exacerbate COVID-19 and worsen associated outcomes by upregulating the enzyme that SARS-CoV-2 binds to enter cells. However, to our knowledge, no study has examined the association between NSAID use and the risk of COVID-19-related outcomes among hospitalised patients.

 

We conducted a population-based cohort study using South Korea nationwide healthcare database, which contains data of all subjects who received a test for COVID-19 (n=69,793) as of April 8, 2020. We identified a cohort of adults hospitalised with COVID-19, where cohort entry was the date of hospitalisation. NSAIDs users were those prescribed NSAIDs in the 7 days before and including the date of cohort entry and non-users were those not prescribed NSAIDs during this period. Our primary outcome was a composite of in-hospital death, intensive care unit admission, mechanical ventilation use, and sepsis; our secondary outcome was cardiovascular or renal complications.

 

Of 1,824 adults hospitalised with COVID-19 (mean age 49.0 years, standard deviation 19.0 years; female 59%), 354 were NSAIDs users and 1,470 were non-users. Compared with non-use, NSAIDs use was associated with increased risks of the primary composite outcome (OR 1.65, 95% CI 1.21-2.24) and of cardiovascular or renal complications (OR 1.87, 95% CI 1.25-2.80). Our main findings remained consistent when we extended the exposure ascertainment window to include the first three days of hospitalisation (OR 1.87, 95% CI 1.06-3.29).

 

Use of NSAIDs, compared with non-use, is associated with worse outcomes among hospitalised COVID-19 patients. While awaiting the results of confirmatory studies, we suggest NSAIDs be used with caution among patients with COVID-19 as the harms associated with their use may outweigh their benefits in this population.

 

Preprint Available at medRxiv (June 16, 2020):

https://doi.org/10.1101/2020.06.01.20119768