Risk of stroke associated with use of nonsteroidal anti‐inflammatory drugs during acute respiratory infection episode

Abstract

Nonsteroidal anti-inflammatory drugs use during ARI episodes, especially parenteral NSAIDs use, was associated with a further increased risk of stroke.

Can Activation of NRF2 Be a Strategy against COVID-19?

“…Although results with NSAIDs are not conclusive in people with COVID-19 [ 102 ], ibuprofen, an NSAID, has been shown to impair neutrophil function, their recruitment to the inflammatory site, and the resolution of inflammatory processes in patients with pneumonia [ 103 ]. However, ibuprofen is associated with higher rates of nephrotoxicity [ 104 ], cardiovascular disease, and stroke [ 105 ], and appears to increase the risk for these outcomes in ARDS [ 106 ]. A significant difference between NSAIDs and NRF2 activators is that NRF2 elicits a much more integrated regulation of the inflammatory response because it is necessary for both execution and resolution.…”

Non-steroidal anti-inflammatory drugs and covid-19

“…In observational studies, long term use of NSAIDs such as ibuprofen, naproxen, and diclofenac has been associated with higher rates of cardiovascular outcomes such as myocardial infarction, heart failure, and stroke2—albeit with ongoing debate about residual confounding 3. Acute respiratory tract infections are already associated with increased risk of stroke and myocardial infarction, and short term use of NSAIDs during the illness is associated with further increases in risk 45. NSAIDs cause nephrotoxicity,67 which is more likely among the patient groups most likely to be seriously affected by covid-19 and is exacerbated by fever and dehydration.…”

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

“…However, since the use of both NSAIDs and acetaminophen could be associated with a masking of the symptoms during COVID-19, and thus to a diagnostic delay and a prolonged illness, complications may be more common when NSAIDs are used-both respiratory and cardiovascular [66]. In patients with acute respiratory infection, NSAIDs have been widely used and evidence suggests that in these circumstances NSAIDs are associated with an increased risk of stroke and myocardial infarction [67][68][69]. Moreover, large randomized trials support that NSAIDs may cause more prolonged illness or complications when taken during respiratory tract infections [70,71].…”