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NSAIDs and COVID-19: A Systematic Review and Meta-analysis.
Moore, Nicholas; Bosco-Levy, Pauline; Thurin, Nicolas; Blin, Patrick; Droz-Perroteau, Cécile.
  • Moore N; Bordeaux PharmacoEpi, Inserm CIC 1401, University of Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France. Nicholas.moore@u-bordeaux.fr.
  • Bosco-Levy P; Bordeaux PharmacoEpi, Inserm CIC 1401, University of Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France.
  • Thurin N; Bordeaux PharmacoEpi, Inserm CIC 1401, University of Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France.
  • Blin P; Bordeaux PharmacoEpi, Inserm CIC 1401, University of Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France.
  • Droz-Perroteau C; Bordeaux PharmacoEpi, Inserm CIC 1401, University of Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France.
Drug Saf ; 44(9): 929-938, 2021 09.
Article in English | MEDLINE | ID: covidwho-1392051
ABSTRACT

BACKGROUND:

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been discouraged for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, fearing that they could increase the risk of infection or the severity of SARS-CoV-2.

METHODS:

Original studies providing information on exposure to NSAIDs and coronavirus disease 2019 (COVID-19) outcomes were retrieved and were included in a descriptive analysis and a meta-analysis with Cochrane Revue Manager (REVMAN 5.4), using inverse variance odds ratio (OR) with random- or fixed-effects models.

RESULTS:

Of 92,853 papers mentioning COVID-19, 266 mentioned NSAIDs and 61 mentioned ibuprofen; 19 papers had analysable data. Three papers described NSAID exposure and the risk of SARS-CoV-2 positivity, five papers described the risk of hospital admission in positive patients, 10 papers described death, and six papers described severe composite outcomes. Five papers studied exposure to ibuprofen and death. Using random-effects models, there was no excess risk of SARS-CoV-2 positivity (OR 0.86, 95% confidence interval [CI] 0.71-1.05). In SARS-CoV-2-positive patients, exposure to NSAIDs was not associated with excess risk of hospital admission (OR 0.90, 95% CI 0.80-1.17), death (OR 0.88, 95% CI 0.80-0.98), or severe outcomes (OR 1.14, 95% CI 0.90-1.44). With ibuprofen, there was no increased risk of death (OR 0.94, 95% CI 0.78-1.13). Using a fixed-effect model did not modify the results, nor did the sensitivity analyses.

CONCLUSION:

The theoretical risks of NSAIDs or ibuprofen in SARS-CoV-2 infection are not confirmed by observational data.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Anti-Inflammatory Agents, Non-Steroidal / COVID-19 / COVID-19 Drug Treatment / Hospitalization Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Drug Saf Journal subject: Drug Therapy / Toxicology Year: 2021 Document Type: Article Affiliation country: S40264-021-01089-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Anti-Inflammatory Agents, Non-Steroidal / COVID-19 / COVID-19 Drug Treatment / Hospitalization Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Drug Saf Journal subject: Drug Therapy / Toxicology Year: 2021 Document Type: Article Affiliation country: S40264-021-01089-5