Prior Routine use of Non-Steroidal Anti-2 Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19

TY - JOUR

T1 - Prior Routine use of Non-Steroidal Anti-2 Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19

AU - Bruce, Eilidh

AU - Barlow-Pay, Fenella

AU - Short, Roxanna

AU - Vilches-Moraga, Arturo

AU - Price, Angeline

AU - McGovern, Aine

AU - Braude, Philip

AU - Stechman, Michael

AU - Moug, Susan

AU - McCarthy, Kathryn

AU - Hewitt, Jonathan

AU - Carter, Ben

AU - Myint, Phyo

PY - 2020/8/4

Y1 - 2020/8/4

N2 - 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 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 hospitalized patients with COVID-19 infection. This was a multi-centre, 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 hospitalized 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 regards to survival. However, as this finding was underpowered further research is required.

AB - 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 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 hospitalized patients with COVID-19 infection. This was a multi-centre, 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 hospitalized 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 regards to survival. However, as this finding was underpowered further research is required.

M3 - Article

SN - 2077-0383

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

ER -