Use of non-steroidal anti-inflammatory drugs and adverse outcomes during the COVID-19 pandemic: A systematic review and meta-analysis

Zhou, Qi; Zhao, Song; Gan, Lidan; Wang, Zhili; Peng, Shuai; Li, Qinyuan; Liu, Hui; Liu, Xiao; Wang, Zijun; Shi, Qianling; Estill, Janne; Luo, Zhengxiu; Wang, Xiaohui; Liu, Enmei; Chen, Yaolong

doi:10.1016/j.eclinm.2022.101373

Cited by 33 publications

(39 citation statements)

References 62 publications

(59 reference statements)

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“…59 Furthermore, a systematic review and meta-analysis of 40 comparative studies that evaluated over 4•8 million adult cases substantiated that the use of NSAIDs (such as COX-2 inhibitors, ibuprofen, or aspirin) was not significantly associated with a higher risk of SARS-CoV-2 infection, or a greater probability of intensive care unit admis sion, mechanical ventilation, or administration of supplemental oxygen. 60 In summary, growing evidence is becoming available and most of it concludes that for patients with COVID-19 NSAID use does not enhance susceptibility to SARS-CoV-2 infection, nor does it appear to confer an increased risk of worse outcomes.…”

Section: Reviewmentioning

confidence: 99%

Home as the new frontier for the treatment of COVID-19: the case for anti-inflammatory agents

Perico

Cortinovis

Suter

et al. 2023

The Lancet Infectious Diseases

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Section: Reviewmentioning

confidence: 99%

Home as the new frontier for the treatment of COVID-19: the case for anti-inflammatory agents

Perico

Cortinovis

Suter

et al. 2023

The Lancet Infectious Diseases

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“…Our systematic review included 40 studies (37 retrospective cohort studies and three prospective cohort studies) with 4,881,423 adults with COVID-19, with data collected between January 2020 and November 2021 [ 31 ]. During the COVID-19 pandemic, the use of non-steroidal anti-inflammatory drugs (NSAIDs) was shown to potentially reduce mortality (OR 0.89, 95% CI: 0.72 to 1.11; adjusted odds ratio [aOR] 0.71, 95% CI: 0.58 to 0.87 compared with people who did not receive NSAIDs).…”

Section: Resultsmentioning

confidence: 99%

Guidelines for the prevention and management of children and adolescents with COVID-19

Liu

Smyth

et al. 2022

Eur J Pediatr

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Children are the future of the world, but their health and future are facing great uncertainty because of the coronavirus disease 2019 (COVID-19) pandemic. In order to improve the management of children with COVID-19, an international, multidisciplinary panel of experts developed a rapid advice guideline at the beginning of the outbreak of COVID-19 in 2020. After publishing the first version of the rapid advice guideline, the panel has updated the guideline by including additional stakeholders in the panel and a comprehensive search of the latest evidence. All recommendations were supported by systematic reviews and graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Expert judgment was used to develop good practice statements supplementary to the graded evidence-based recommendations. The updated guideline comprises nine recommendations and one good practice statement. It focuses on the key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin (IVIG) for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health. Conclusion : This updated evidence-based guideline intends to provide clinicians, pediatricians, patients and other stakeholders with evidence-based recommendations for the prevention and management of COVID-19 in children and adolescents. Larger studies with longer follow-up to determine the effectiveness and safety of systemic glucocorticoids, IVIG, noninvasive ventilation, and the vaccines for COVID-19 in children and adolescents are encouraged. What is Known: • Several clinical practice guidelines for children with COVID-19 have been developed, but only few of them have been recently updated. • We developed an evidence-based guideline at the beginning of the COVID-19 outbreak and have now updated it based on the results of a comprehensive search of the latest evidence. What is New: • The updated guideline provides key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-022-04615-4.

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“…Furthermore, there is no clear evidence to support that NSAID might worsen the prognosis of COVID-19. 15 The use of NSAIDs in patients with COVID-19 is not associated with higher risk regarding mortality or mechanical ventilation. Patients receiving NSAIDS benefit from the upregulation of ACE-2, and management of pain and fever.…”

Section: Coronavirus Disease 2019 (Covid-19mentioning

confidence: 96%

NSAIDs in COVID-19, friend or foe?

Mahrous¹,

Abdelnasser²,

Fouda³

et al. 2022

Anaesth. pain intensive care

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At the beginning of COVID-19 pandemic the use of NSAIDS was avoided. This was because the previous studies suggesting that NSAIDs may be linked to an increased risk of lower respiratory tract infection consequences. Later on studies involved the patients who used NSAIDs for some chronic conditions and showed no additional harm among these patients. Then many studied assessed the benefit of using NSAIDs in COVID-19 patients for management of pain and fever and showed no additional risk among these patients. Key words: Citation: Mahrous R, Abdelnasser A, Fouda R, Morsy MAM, Ibrahim MA, Mandour O. NSAIDs in COVID-19, friend or foe? Anaesth. pain intensive care 2022;26(4):427-429; DOI: 10.35975/apic.v26i4.1942 Received: May 29, 2022; Reviewed: June 06, 2022, 2022; Accepted: June 06, 2022

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Use of non-steroidal anti-inflammatory drugs and adverse outcomes during the COVID-19 pandemic: A systematic review and meta-analysis

Cited by 33 publications

References 62 publications

Home as the new frontier for the treatment of COVID-19: the case for anti-inflammatory agents

Home as the new frontier for the treatment of COVID-19: the case for anti-inflammatory agents

Guidelines for the prevention and management of children and adolescents with COVID-19

NSAIDs in COVID-19, friend or foe?

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