Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19
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-convertin...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/8/2586 |
| _version_ | 1797559203558064128 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Eilidh Bruce |
| collection | DOAJ |
| description | 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, <i>p</i> = 0.67) or length of stay (aHR 0.89, 95% CI 0.59–1.35, <i>p</i> = 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. |
| first_indexed | 2024-03-10T17:42:04Z |
| format | Article |
| id | doaj.art-c5cbe4e6be144a4398c474d519d89fc2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T17:42:04Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c5cbe4e6be144a4398c474d519d89fc22023-11-20T09:40:53ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0198258610.3390/jcm9082586Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19Eilidh Bruce0Fenella Barlow-Pay1Roxanna Short2Arturo Vilches-Moraga3Angeline Price4Aine McGovern5Philip Braude6Michael J. Stechman7Susan Moug8Kathryn McCarthy9Jonathan Hewitt10Ben Carter11Phyo Kyaw Myint12Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, Scotland, UKRoyal Alexandra Hospital, Paisley PA2 9PJ, Scotland, UKDepartment of Biostatistics & Health Informatics, King’s College London, London WC2R 2LS, UKSalford Royal NHS Trust, Salford M6 8HD, UKSalford Royal NHS Trust, Salford M6 8HD, UKGlasgow Royal Infirmary, Glasgow G4 0SF, Scotland, UKNorth Bristol NHS Trust, Bristol BS10 5NB, UKSchool of Medicine, Cardiff University, Cardiff CF10 3AT, Wales, UKRoyal Alexandra Hospital, Paisley PA2 9PJ, Scotland, UKNorth Bristol NHS Trust, Bristol BS10 5NB, UKSchool of Medicine, Cardiff University, Cardiff CF10 3AT, Wales, UKDepartment of Biostatistics & Health Informatics, King’s College London, London WC2R 2LS, UKAberdeen Royal Infirmary, Aberdeen AB25 2ZN, Scotland, UKCoronavirus 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, <i>p</i> = 0.67) or length of stay (aHR 0.89, 95% CI 0.59–1.35, <i>p</i> = 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.https://www.mdpi.com/2077-0383/9/8/2586covid-19SARS-CoV-2non-steroidal anti-inflammatory drugsNSAIDs |
| spellingShingle | 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 Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19 Journal of Clinical Medicine covid-19 SARS-CoV-2 non-steroidal anti-inflammatory drugs NSAIDs |
| title | Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19 |
| title_full | Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19 |
| title_fullStr | Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19 |
| title_full_unstemmed | Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19 |
| title_short | Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19 |
| title_sort | prior routine use of non steroidal anti inflammatory drugs nsaids and important outcomes in hospitalised patients with covid 19 |
| topic | covid-19 SARS-CoV-2 non-steroidal anti-inflammatory drugs NSAIDs |
| url | https://www.mdpi.com/2077-0383/9/8/2586 |
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