NSAIDs are common treatments for acute pain and rheumatological diseases such as rheumatoid arthritis and osteoarthrosis. Early in the pandemic, there was debate on whether the use of such drugs increased the severity of Covid-19, which led to urgent calls for investigations on link between NSAIDs and Covid-19.
NSAIDs are commonly used to treat people all over the world for a range of conditions, from minor aches and pains to chronic conditions such as arthritis and cardiovascular disease. Many people rely on them to be able to carry out their day-to-day activities.
Prof. Ewen Harrison of the University of Edinburgh, lead author of the study, said, “We needed to be sure these common medications would not lead to worse outcomes in people with Covid-19. We now have clear evidence that NSAIDs are safe to use in Covid-19 patients, which should provide reassurance to both clinicians and patients that they can continue to be used in the same way as before the pandemic began.”
The study was conducted in the UK and involved just over 72,000 patients. The ISARIC CCP-UK (International Severe Acute Respiratory and emerging Infection Consortium Clinical Characterisation Protocol- United Kingdom) studywas the largest of its kind.
Dr Sandeep Mogre, who’s been treating Covid-19 patients at his hospital, agrees. “Use of NSAIDs is definitely not an issue but there is a protocol that must be followed. Treatment has to start first with paracetamol. Then, if needed, ibuprofen, then asprin, etc,” said Dr Mogre.
In the study, around a third of patients (30.4% or 1,279 out of 4,211) who had taken NSAIDs prior to hospital admission for Covid-19 died, a rate which was similar (31.3% or 21,256 out of 67,968) in patients who had not taken NSAIDs. In patients with rheumatological disease also, the use of NSAIDs did not increase mortality.
Modelling analyses were used to estimate the effects of NSAIDs taken prior to hospitalisation on mortality rates in hospital, disease severity, admission to critical care, requirement for invasive or non-invasive ventilation, use of supplemental oxygen, or development of acute kidney injury, which were then compared to patients who had not taken NSAIDs. Those who took NSAIDs were no more likely to be admitted to critical care, need invasive or non-invasive ventilation, or require oxygen.
The study collected data on the medication patients had been prescribed, were currently taking, or had taken within 14 days prior to being admitted to hospital, as well as demographic information, and medical history.