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Open AccessArticle

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

Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, Scotland, UK
Institute of Applied Health Science, University of Aberdeen, Aberdeen AB25 2ZN, Scotland, UK
Royal Alexandra Hospital, Paisley PA2 9PJ, Scotland, UK
Department of Biostatistics & Health Informatics, King’s College London, London WC2R 2LS, UK
Salford Royal NHS Trust, Salford M6 8HD, UK
Glasgow Royal Infirmary, Glasgow G4 0SF, Scotland, UK
North Bristol NHS Trust, Bristol BS10 5NB, UK
School of Medicine, Cardiff University, Cardiff CF10 3AT, Wales, UK
Author to whom correspondence should be addressed.
These authors contributed equally.
These authors joint first authors.
These authors joint last authors.
J. Clin. Med. 2020, 9(8), 2586;
Received: 12 June 2020 / Revised: 14 July 2020 / Accepted: 4 August 2020 / Published: 10 August 2020
(This article belongs to the Special Issue COVID-19: From Pathophysiology to Clinical Practice)
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. View Full-Text
Keywords: covid-19; SARS-CoV-2; non-steroidal anti-inflammatory drugs; NSAIDs covid-19; SARS-CoV-2; non-steroidal anti-inflammatory drugs; NSAIDs
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Bruce, E.; Barlow-Pay, F.; Short, R.; Vilches-Moraga, A.; Price, A.; McGovern, A.; Braude, P.; Stechman, M.J.; Moug, S.; McCarthy, K.; Hewitt, J.; Carter, B.; Myint, P.K. Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19. J. Clin. Med. 2020, 9, 2586.

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