Prior routine use of non-sterioda anti-inflammatory drugs (NSAIDs) and important outcomes in hospitalised patients with COVID-19

Bruce, Eilidh, Barolw-Pay, Fenella, Short, Roxanna, Vilches-Moraga, Arturo, Price, Angeline, McGovern, Aine, Braude, Philip, Stechman, Michael, Moug, Susan, McCarthy, Kathryn, Hewitt, Jonathan ORCID: https://orcid.org/0000-0002-7924-1792, Carter, Ben and Myint, Phyo K. 2020. Prior routine use of non-sterioda anti-inflammatory drugs (NSAIDs) and important outcomes in hospitalised patients with COVID-19. Journal of Clinical Medicine 9 (8) , 2586. 10.3390/jcm9082586

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)
Publisher:	MDPI
ISSN:	2077-0383
Date of First Compliant Deposit:	4 August 2020
Date of Acceptance:	4 August 2020
Last Modified:	10 Jun 2023 22:45
URI:	https://orca.cardiff.ac.uk/id/eprint/133939

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