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Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID-19.
Chandan, Joht Singh; Zemedikun, Dawit Tefra; Thayakaran, Rasiah; Byne, Nathan; Dhalla, Samir; Acosta-Mena, Dionisio; Gokhale, Krishna M; Thomas, Tom; Sainsbury, Christopher; Subramanian, Anuradhaa; Cooper, Jennifer; Anand, Astha; Okoth, Kelvin O; Wang, Jingya; Adderley, Nicola J; Taverner, Thomas; Denniston, Alastair K; Lord, Janet; Thomas, G Neil; Buckley, Christopher D; Raza, Karim; Bhala, Neeraj; Nirantharakumar, Krishnarajah; Haroon, Shamil.
  • Chandan JS; Institute of Applied Health Research, University of Birmingham, Birmingham, UK, and Warwick Medical School, University of Warwick, Coventry, UK.
  • Zemedikun DT; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Thayakaran R; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Byne N; Cegedim Rx, London, UK.
  • Dhalla S; Cegedim Rx, London, UK.
  • Acosta-Mena D; Cegedim Rx, London, UK.
  • Gokhale KM; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Thomas T; Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK.
  • Sainsbury C; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Subramanian A; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Cooper J; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Anand A; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Okoth KO; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Wang J; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Adderley NJ; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Taverner T; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Denniston AK; Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Lord J; Institute of Inflammation and Ageing, University of Birmingham, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK.
  • Thomas GN; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
  • Buckley CD; Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK, and Institute of Inflammation and Ageing, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK.
  • Raza K; Institute of Inflammation and Ageing, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Sandwell and West Birmingham NHS Hospitals Trust, Birmingham, UK.
  • Bhala N; Institute of Applied Health Research, University of Birmingham, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Nirantharakumar K; Institute of Applied Health Research, University of Birmingham, Health Data Research UK Midlands, Birmingham, UK.
  • Haroon S; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Arthritis Rheumatol ; 73(5): 731-739, 2021 05.
Article in English | MEDLINE | ID: covidwho-1206744
ABSTRACT

OBJECTIVE:

To identify whether active use of nonsteroidal antiinflammatory drugs (NSAIDs) increases susceptibility to developing suspected or confirmed coronavirus disease 2019 (COVID-19) compared to the use of other common analgesics.

METHODS:

We performed a propensity score-matched cohort study with active comparators, using a large UK primary care data set. The cohort consisted of adult patients age ≥18 years with osteoarthritis (OA) who were followed up from January 30 to July 31, 2020. Patients prescribed an NSAID (excluding topical preparations) were compared to those prescribed either co-codamol (paracetamol and codeine) or co-dydramol (paracetamol and dihydrocodeine). A total of 13,202 patients prescribed NSAIDs were identified, compared to 12,457 patients prescribed the comparator drugs. The primary outcome measure was the documentation of suspected or confirmed COVID-19, and the secondary outcome measure was all-cause mortality.

RESULTS:

During follow-up, the incidence rates of suspected/confirmed COVID-19 were 15.4 and 19.9 per 1,000 person-years in the NSAID-exposed group and comparator group, respectively. Adjusted hazard ratios for suspected or confirmed COVID-19 among the unmatched and propensity score-matched OA cohorts, using data from clinical consultations in primary care settings, were 0.82 (95% confidence interval [95% CI] 0.62-1.10) and 0.79 (95% CI 0.57-1.11), respectively, and adjusted hazard ratios for the risk of all-cause mortality were 0.97 (95% CI 0.75-1.27) and 0.85 (95% CI 0.61-1.20), respectively. There was no effect modification by age or sex.

CONCLUSION:

No increase in the risk of suspected or confirmed COVID-19 or mortality was observed among patients with OA in a primary care setting who were prescribed NSAIDs as compared to those who received comparator drugs. These results are reassuring and suggest that in the absence of acute illness, NSAIDs can be safely prescribed during the ongoing pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteoarthritis / Anti-Inflammatory Agents, Non-Steroidal / Mortality / COVID-19 / Analgesics Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Arthritis Rheumatol Year: 2021 Document Type: Article Affiliation country: Art.41593

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteoarthritis / Anti-Inflammatory Agents, Non-Steroidal / Mortality / COVID-19 / Analgesics Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Arthritis Rheumatol Year: 2021 Document Type: Article Affiliation country: Art.41593