The risk of mortality in patients with COVID-19 with pre-diagnosis use of NSAIDs: a meta-analysis

Kow, Chia Siang; Hasan, Syed Shahzad

doi:10.1007/s10787-021-00810-1

Cited by 16 publications

(10 citation statements)

References 11 publications

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“…Large meta-analyses have shown that neither RAAS, nor other antihypertensive drugs, nor NSAIDs are associated with increased risk of death. The reason for previous observations was not the influence of drugs on COVID-19, but it was the effect of underlying comorbidities alone [19,20]. Moreover, statins, due to their anti-inflammatory effect, are associated with lower risk of fatal COVID-19 [21][22][23] among non-ICU patients and lower risk of mechanical ventilation treatment [22].…”

Section: Discussionmentioning

confidence: 99%

The Value of Clinical Frailty Scale (CFS) as a Prognostic Tool in Predicting Mortality in COVID-19—A Retrospective Cohort Study

Jachymek

Cader

Ptak

et al. 2022

IJERPH

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Background: Due to the unpredictable nature of COVID-19, there is a need to identify patients at high risk of severe course of the disease and a higher mortality rate. Objective: This study aims to find the correlation between frailty and mortality in adult, hospitalized patients with COVID-19. Methods: Clinical records of 201 patients who suffered from COVID-19 and were hospitalized between October 2020 and February 2021 were retrospectively analyzed. Demographic, clinical, and biochemical data were collected. Patients were assessed using Clinical Frailty Scale (CFS) and were divided into three groups: CFS 1–3 fit; CFS 4–6 vulnerable and with mild to moderate frailty; CSF 7–9, severe frailty. The association between frailty and in-hospital mortality was the primary outcome. Results: Severe frailty or terminal illness was observed in 26 patients (12.94%) from a cohort of 201 patients. Those patients were older (median age 80.73, p < 0.001) and had more comorbidities. Frailty was also associated with higher requirement for oxygen supplementation, greater risk of in-hospital complications and worse biochemical laboratory results. An increase in CFS score also correlated with higher mortality (OR = 1.727, p < 0.001). The Conclusions: Clinical Frailty Scale (CFS) can be used as a potentially useful tool in predicting mortality in patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

The Value of Clinical Frailty Scale (CFS) as a Prognostic Tool in Predicting Mortality in COVID-19—A Retrospective Cohort Study

Jachymek

Cader

Ptak

et al. 2022

IJERPH

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“…Nineteen of the studies were conducted in patients with COVID-19 or SARS-CoV-2 infection, and the number of participants ranged from 103 to 2.74 million. In addition, a meta-analysis that included 2414 patients from three studies was retrieved 29 .…”

Section: Resultsmentioning

confidence: 99%

“…A meta-analysis by Kow and Hasan included data from 2414 patients across three studies that compared COVID-19 patients who were users or non-users of NSAIDs 29 . A pooled HR of 0.86 (95% CI 0.49–1.51) demonstrated no significant difference in the risk of fatality between NSAID users and non-NSAID users.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 24 relevant publications identified, the overwhelming majority are consistent in showing that NSAIDs neither increase the likelihood of SARS-CoV-2 infection nor worsen clinical outcomes in patients with COVID-19. In addition, a metaanalysis demonstrated no increase in risk of mortality among NSAID users vs. non-NSAID users 29 . Another, very recent, systematic review and meta-analysis published after the cut-off of our search found no excess risk of SARS-CoV-2 positivity in patients exposed to NSAIDs 15 .…”

Section: Discussionmentioning

confidence: 98%

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The use of non-steroidal anti-inflammatory drugs (NSAIDs) in COVID-19

Kushner

McCarberg

Grange

et al. 2022

npj Prim. Care Respir. Med.

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Early in the COVID-19 pandemic, anecdotal reports emerged suggesting non-steroidal anti-inflammatory drugs (NSAIDs) may increase susceptibility to infection and adversely impact clinical outcomes. This narrative literature review (March 2020–July 2021) attempted to clarify the relationship between NSAID use and COVID-19 outcomes related to disease susceptibility or severity. Twenty-four relevant publications (covering 25 studies) reporting original research data were identified; all were observational cohort studies, and eight were described as retrospective. Overall, these studies are consistent in showing that NSAIDs neither increase the likelihood of SARS-CoV-2 infection nor worsen outcomes in patients with COVID-19. This is reflected in current recommendations from major public health authorities across the world, which support NSAID use for analgesic or antipyretic treatment during COVID-19. Thus, there is no basis on which to restrict or prohibit use of these drugs by consumers or patients to manage their health conditions and symptoms during the pandemic.

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“… 74 Several meta-analyses have shown that using NSAIDs, including ibuprofen, does not increase the risk of serious complications such as severe acute respiratory distress syndrome (ARDS), hospitalization, ICU admission, and death, in patients both confirmed and suspected of SARS CoV-2 infection. 75 , 76 …”

Section: Drug Used For Self-medication In Covid-19mentioning

confidence: 99%

Drug safety of frequently used drugs and substances for self-medication in COVID-19

Baracaldo-Santamaría

Pabón-Londoño

Rojas-Rodriguez

2022

Therapeutic Advances in Drug Safety

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During the COVID-19 pandemic, the behavior of self-medication has increased. The dissemination of misleading information regarding the efficacy of certain drugs or substances for the prevention and treatment of COVID-19 has been the major contributing factor for this phenomenon. Alongside with the increase in self-medication behavior, the inherent risks to this act such as drug–drug interactions, adverse events, drug toxicity, and masking of symptoms have also increased. Self-medication in the context of COVID-19 has led to drug misuse leading in some cases to the development of fatal adverse drug reactions. It is important that during this ongoing pandemic drugs with potential clinical efficacy against COVID-19 are adequately analyzed regarding their efficacy, safety, and monitoring. The aim of this review is to describe the available evidence regarding the efficacy, safety, and monitoring of the drugs and substances that have been shown to be frequently used for self-medication in patients with COVID-19 (hydroxychloroquine, non-steroidal anti-inflammatory drugs, ivermectin, azithromycin, vitamins, aspirin, and chlorine dioxide) to adequately characterize their risks, safe use, monitoring strategies, and to reinforce the concept that these substances should not be used for self-medication and require a medical prescription. Plain Language Summary Drug safety of frequently used drugs and substances for self-medication in COVID-19 Dissemination of information about potential COVID-19 treatments has led individuals to self-medicate and expose themselves to risks such as drug–drug interactions, side effects, antibiotic resistance, and misdiagnosis. There is a need to review the medical literature to evaluate the safety and efficacy of the drugs and substances commonly used by the population for the treatment and prevention of SARS CoV-2 infection. In this review, we included drugs that are frequently used for self-medication and commonly advertised such as ivermectin, hydroxychloroquine, chlorine dioxide, azithromycin, and non-steroidal anti-inflammatory drugs, among others. A brief introduction of the drug and its mechanism of action, followed by a summary of the efficacy in COVID-19 and safety, will be described for each drug in order to promote their responsible use.

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The risk of mortality in patients with COVID-19 with pre-diagnosis use of NSAIDs: a meta-analysis

Cited by 16 publications

References 11 publications

The Value of Clinical Frailty Scale (CFS) as a Prognostic Tool in Predicting Mortality in COVID-19—A Retrospective Cohort Study

The Value of Clinical Frailty Scale (CFS) as a Prognostic Tool in Predicting Mortality in COVID-19—A Retrospective Cohort Study

The use of non-steroidal anti-inflammatory drugs (NSAIDs) in COVID-19

Drug safety of frequently used drugs and substances for self-medication in COVID-19

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