ABSTRACT
Background/Introduction: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID);it is considered as relatively safe and is widely used in the world. However, at the beginning of the COVID-19 pandemic, ibuprofen was associated with an increase in severity or mortality of the infection [1-4]. Objective/Aim: To conduct a meta-analysis of the association between ibuprofen use and SARS-CoV-2 infection severity or mortality. Methods: We searched PubMed, EMBASE, Google Scholar and the Cochrane Database of Systematic Reviews for observational studies published between January 2020 and May 2021. Studies were included if they contained data on ibuprofen use and SARS-CoV-2 infection severity or mortality. Information upon study design, location, year of publication, number of participants, sex, age at baseline, outcome and exposure definitions was gathered. The quality of studies included was assessed with the Newcastle-Ottawa Scale (NOS). The analysis was performed based on a random-effects model;the summary effect and its confidence interval were calculated. Results: Eight observational studies comprising a total of 1785.730 participants were identified for inclusion (cohort, 5;case-control, 2;cross-sectional, 1). Mean age was 54.4 (SD 12.6) years-old and 50.2% were men. The mean NOS score of included studies was 7.7 (range 7-9). The studies were from Austria, Denmark (2), Israel, Saudi Arabia, UK (2) and USA. Patients exposed to ibuprofen while infected with SARS-CoV-2 had not higher severity or mortality;summary odds ratios were 0.81 (95% CI 0.58-1.12, p = 0.14) and 0.95 (95% CI 0.79-1.14, p = 0.42), respectively. Conclusion: At present, the available evidence does not support the hypothesis of an increased SARS-CoV-2 risk associated with ibuprofen. However, more evidence needs to accumulate before this controversy can be resolved.