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Association Between Nonsteroidal Antiinflammatory Drug Use and Adverse Clinical Outcomes Among Adults Hospitalized With Coronavirus 2019 in South Korea: A Nationwide Study.
Jeong, Han Eol; Lee, Hyesung; Shin, Hyun Joon; Choe, Young June; Filion, Kristian B; Shin, Ju-Young.
  • Jeong HE; Department of Clinical and Social Pharmacy, School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea.
  • Lee H; Department of Clinical and Social Pharmacy, School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea.
  • Shin HJ; Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, and Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
  • Choe YJ; Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, South Korea.
  • Filion KB; Departments of Medicine and of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
  • Shin JY; Centre for Clinical Epidemiology, Lady Davis Institute, Montreal, Quebec, Canada.
Clin Infect Dis ; 73(11): e4179-e4188, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1561122
ABSTRACT

BACKGROUND:

Nonsteroidal antiinflammatory drugs (NSAIDs) may exacerbate coronavirus disease 2019 (COVID-19) and worsen associated outcomes by upregulating the enzyme that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binds to in order to enter cells.

METHODS:

We conducted a cohort study using South Korea's nationwide healthcare database, which contains data for all individuals who received a COVID-19 test (n = 69 793) as of 8 April 2020. We identified adults hospitalized with COVID-19, where cohort entry was the date of hospitalization. NSAID users were those prescribed NSAIDs in the 7 days before and including cohort entry, and nonusers were those not prescribed NSAIDs during this period. Our primary outcome was a composite of in-hospital death, intensive care unit admission, mechanical ventilation use, and sepsis; our secondary outcomes were cardiovascular complications and acute renal failure. We conducted logistic regression analysis to estimate odds ratio (OR) with 95% confidence intervals (CIs) using inverse probability of treatment weighting to minimize confounding.

RESULTS:

Of 1824 adults hospitalized with COVID-19 (mean age, 49.0 years; female, 59%), 354 were NSAID users and 1470 were nonusers. Compared with nonuse, NSAID use was associated with increased risks of the primary composite outcome (OR, 1.54; 95% CI, 1.13-2.11) but insignificantly associated with cardiovascular complications (OR, 1.54; 95% CI, 0.96-2.48) or acute renal failure (OR, 1.45; 95% CI, 0.49-4.14).

CONCLUSIONS:

While awaiting the results of confirmatory studies, we suggest NSAIDs be used with caution for COVID-19 patients as the harms associated with their use may outweigh their benefits.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Middle aged Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Middle aged Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid