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

Kushner, Pamela; McCarberg, Bill; Grange, Laurent; Kolosov, Anton; Haveric, Anela Lihic; Zucal, Vincent; Petruschke, Richard; Bissonnette, Stephane

doi:10.1038/s41533-022-00300-z

Cited by 39 publications

(30 citation statements)

References 50 publications

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“…In a recent study, the analysis of aspirin users was part of the larger study of smartphone app users from the United States, United Kingdom, and Sweden. The study showed that the probability of developing COVID-19 in this group was not substantially different from those who did not use any NSAIDs (HR after adjustment: 1.03 [95% CI 0.83–1.28]) ( Kushner et al, 2022 ).…”

Section: Nsaids In Covid-19 Managementmentioning

confidence: 96%

Efficacy and safety profile of corticosteroids and non-steroidal anti-inflammatory drugs in COVID-19 management: A narrative review

Amponsah

Tagoe²,

Adams

et al. 2022

Front. Pharmacol.

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Due to the fact that coronavirus disease 2019 (COVID-19) is still prevalent, and current reports show that some parts of the world have seen increase in incidence, it is relevant that health professionals and scientists know about recent or novel trends, especially drug treatments. Additionally, the safety profiles of these drug treatments need to be documented and shared with the public. Some studies have demonstrated the clinical benefits of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids in COVID-19 treatment. On the contrary, others have also reported that NSAIDs and corticosteroids may worsen symptoms associated with COVID-19. While some researchers have suggested that corticosteroids may be helpful if used in the early stages of COVID-19, there are still some conflicting findings regarding the use of corticosteroids in certain viral infections. Our review suggests that methylprednisolone, dexamethasone, and ibuprofen have therapeutic potential in reducing mortality due to COVID-19 among hospitalized patients. This review also highlights the fact that the use of NSAIDs is not associated with adverse outcomes of COVID-19. In reality, evidence suggests that NSAIDs do not increase the risk of COVID-19 infections. Also, the literature reviewed suggests that corticosteroid treatment in COVID-19 was linked with a decrease in all-cause mortality and disease progression, without increase in adverse events when compared to no corticosteroid treatment.

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Section: Nsaids In Covid-19 Managementmentioning

confidence: 96%

Efficacy and safety profile of corticosteroids and non-steroidal anti-inflammatory drugs in COVID-19 management: A narrative review

Amponsah

Tagoe²,

Adams

et al. 2022

Front. Pharmacol.

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“…Therapeutics trialed and utilized before and during COVID-19 disease (e.g., methylprednisolone and dexamethasone) naturally can have non-specific anti-inflammatory and specific functions to decrease inflammation in different pathologies affected by multiple cellular pathways [ 226 ]. Therefore, some of the COVID-19-disease-related pathologies, such as lung fibrosis that is associated with alveolar injury, oedema, hypoxia, and inflammation, would, in effect, be reduced while the immune system responds; however, these are subject to local pharmacovigilance and monitoring studies [ 261 , 262 , 263 , 264 ].…”

Section: Inflammatory Cells and Phagocytesmentioning

confidence: 99%

Innate and Adaptive Immunity during SARS-CoV-2 Infection: Biomolecular Cellular Markers and Mechanisms

Brown¹,

Ojha²,

Fricke³

et al. 2023

Vaccines

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The coronavirus 2019 (COVID-19) pandemic was caused by a positive sense single-stranded RNA (ssRNA) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, other human coronaviruses (hCoVs) exist. Historical pandemics include smallpox and influenza, with efficacious therapeutics utilized to reduce overall disease burden through effectively targeting a competent host immune system response. The immune system is composed of primary/secondary lymphoid structures with initially eight types of immune cell types, and many other subtypes, traversing cell membranes utilizing cell signaling cascades that contribute towards clearance of pathogenic proteins. Other proteins discussed include cluster of differentiation (CD) markers, major histocompatibility complexes (MHC), pleiotropic interleukins (IL), and chemokines (CXC). The historical concepts of host immunity are the innate and adaptive immune systems. The adaptive immune system is represented by T cells, B cells, and antibodies. The innate immune system is represented by macrophages, neutrophils, dendritic cells, and the complement system. Other viruses can affect and regulate cell cycle progression for example, in cancers that include human papillomavirus (HPV: cervical carcinoma), Epstein–Barr virus (EBV: lymphoma), Hepatitis B and C (HB/HC: hepatocellular carcinoma) and human T cell Leukemia Virus-1 (T cell leukemia). Bacterial infections also increase the risk of developing cancer (e.g., Helicobacter pylori). Viral and bacterial factors can cause both morbidity and mortality alongside being transmitted within clinical and community settings through affecting a host immune response. Therefore, it is appropriate to contextualize advances in single cell sequencing in conjunction with other laboratory techniques allowing insights into immune cell characterization. These developments offer improved clarity and understanding that overlap with autoimmune conditions that could be affected by innate B cells (B1+ or marginal zone cells) or adaptive T cell responses to SARS-CoV-2 infection and other pathologies. Thus, this review starts with an introduction into host respiratory infection before examining invaluable cellular messenger proteins and then individual immune cell markers.

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“…Despite initial concern regarding the use of NSAIDs in the setting of a COVID-19 infection, current guidelines per the World Health Organization and Food and Drug Administration have not acknowledged any link between NSAIDs and worsening COVID-19 symptoms or outcomes [39 , 40], and recent studies do not support restricting the use of NSAIDs [41][42][43]. In the absence of robust evidence on the management of COVID-19-associated pericarditis, standard treatments for pericarditis, including NSAIDs, corticosteroids, colchicine, and anakinra, have been used safely in the setting of SARS-COV2 infection [34,44].…”

Section: Pericarditis Due To Covid-19 Infection and Covid-19 Vaccinationmentioning

confidence: 99%

Pediatric Pericarditis: Update

et al. 2023

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Purpose of Review While there have now been a variety of large reviews on adult pericarditis, this detailed review specifically focuses on the epidemiology, clinical presentation, diagnosis, and management of pediatric pericarditis. We have tried to highlight most pediatric studies conducted on this topic, with special inclusion of important adult studies that have shaped our understanding of and management for acute and recurrent pericarditis. Recent Findings We find that the etiology of pediatric pericarditis differs from adult patients with pericarditis and has evolved over the years. Also, with the current COVID-19 pandemic, it is important for pediatric clinicians to be aware of pericardial involvement both due to the infection and from vaccination. Oftentimes, pericarditis maybe the only cardiac involvement in children with COVID-19, and so caregivers should maintain a high index of suspicion when they encounter children with pericarditis. Summary Large-scale contemporary epidemiological data regarding incidence and prevalence of both acute and recurrent pericarditis is lacking in pediatrics, and future studies should focus on highlighting this important research gap. Most of the current management strategies for pediatric pericarditis are from experiences gathered from adult data. Pediatric multicenter trials are warranted to understand the best management strategy for those with acute and recurrent pericarditis. Case Vignette A 6-year-old child with a past history of pericarditis almost 2 months ago comes in with a 2-day history of chest pain and fever. Per mother, he stopped his steroids about 2 weeks ago, and for the last 2 days has had a temperature of 102F and has been complaining of sharp mid-sternal chest pain that gets worse when he lies down and is relieved when he sits up and leans forward. On examination, he is tachycardic (heart rate 160 bpm), with normal blood pressure for age. He appears to be in pain (5/10), and on auscultation has a pericardial friction rub. His lab studies are notable for elevated white blood cell count and inflammatory markers (CRP and ESR). His electrocardiogram reveals sinus tachycardia and diffuse ST-elevation in all precordial leads. His echocardiogram demonstrates normal biventricular function and a trace pericardial effusion. His cardiac MRI confirms recurrent pericarditis. He is started on indomethacin and colchicine. He has complete resolution of his symptoms by day 3 of admission and is discharged with close follow-up.

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

Cited by 39 publications

References 50 publications

Efficacy and safety profile of corticosteroids and non-steroidal anti-inflammatory drugs in COVID-19 management: A narrative review

Efficacy and safety profile of corticosteroids and non-steroidal anti-inflammatory drugs in COVID-19 management: A narrative review

Innate and Adaptive Immunity during SARS-CoV-2 Infection: Biomolecular Cellular Markers and Mechanisms

Pediatric Pericarditis: Update

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