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. 2021 May;73(5):731-739.
doi: 10.1002/art.41593.

Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID-19

Joht Singh Chandan  1 , Dawit Tefra Zemedikun  2 , Rasiah Thayakaran  2 , Nathan Byne  3 , Samir Dhalla  3 , Dionisio Acosta-Mena  3 , Krishna M Gokhale  2 , Tom Thomas  4 , Christopher Sainsbury  2 , Anuradhaa Subramanian  2 , Jennifer Cooper  2 , Astha Anand  2 , Kelvin O Okoth  2 , Jingya Wang  2 , Nicola J Adderley  2 , Thomas Taverner  2 , Alastair K Denniston  5 , Janet Lord  6 , G Neil Thomas  2 , Christopher D Buckley  7 , Karim Raza  8 , Neeraj Bhala  9 , Krishnarajah Nirantharakumar  10 , Shamil Haroon  2
Affiliations

Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID-19

Joht Singh Chandan et al. Arthritis Rheumatol. 2021 May.

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.

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Figures

Figure 1
Figure 1
Flow chart showing disposition of the osteoarthritis patients in each group. MSK = musculoskeletal; NSAIDs = nonsteroidal antiinflammatory drugs; GI = gastrointestinal.
Figure 2
Figure 2
Adjusted hazard ratio (aHR) (with 95% confidence interval [95% CI]) for developing suspected/confirmed coronavirus disease 2019 (COVID‐19) or mortality following medication use in both the exposed group and the comparator group. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/art.41593/abstract.
See this image and copyright information in PMC

References

    1. World Health Organization . Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019‐nCoV). January 2020. URL: https://www.who.int/news‐room/detail/30‐01‐2020‐statement‐on‐the‐second‐....
    1. John Hopkins University . COVID‐19 Cashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). URL: https://coronavirus.jhu.edu/map.html.
    1. Basille D, Thomsen RW, Madsen M, Duhaut P, Andrejak C, Jounieaux V, et al. Nonsteroidal antiinflammatory drug use and clinical outcomes of community‐acquired pneumonia. Am J Respir Crit Care Med 2018;198:128–31. - PubMed
    1. Le Bourgeois M, Ferroni A, Leruez‐Ville M, Varon E, Thumerelle C, Brémont F, et al. Nonsteroidal anti‐inflammatory drug without antibiotics for acute viral infection increases the empyema risk in children: a matched case‐control study. J Pediatr 2016;175:47–53. - PMC - PubMed
    1. Voiriot G, Philippot Q, Elabbadi A, Elbim C, Chalumeau M, Fartoukh M. Risks related to the use of non‐steroidal anti‐inflammatory drugs in community‐acquired pneumonia in adult and pediatric patients [review]. J Clin Med 2019;8:786. - PMC - PubMed

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