by Molly Walker, Deputy Managing Editor, MedPage Today May 7, 2021

Kerfuffle Over NSAIDs in COVID Finally Resolved?

— Largest study ever sheds more light on an early pandemic controversy

There was no association between use of non-steroidal anti-inflammatory drugs (NSAIDs) and increased disease severity or mortality among patients with COVID-19 requiring hospitalization, a U.K. cohort study found.

After adjusting for confounders, in-hospital mortality for patients who were taking NSAIDs prior to admission was no different from those who were not (matched OR 0.95, 95% CI 0.84-1.07), reported Ewan Harrison, PhD, of the University of Edinburgh in Scotland, and colleagues.

Moreover, NSAID use was not associated with critical care admission (matched OR 1.01, 95% CI 0.87-1.17), or the need for invasive (matched OR 0.96, 95% CI 0.80-1.17) or non-invasive ventilation (matched OR 1.12, 95% CI 0.96-1.32), the authors wrote in The Lancet Rheumatology.

NSAIDs were implicated in the severity of COVID-19 back in March 2020, when the French health ministry cited unpublished data showing they could increase disease severity, but later research found no associations between the drug and worse outcomes.

“We now have clear evidence that NSAIDs are safe to use in patients with COVID-19, 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,” Harrison said in a statement.

In the largest study to date, Harrison’s group examined data from a cohort of around 79,000 patients from 255 healthcare facilities in the U.K. from January to August 2020. Participants included hospitalized patients with confirmed or suspected SARS-CoV-2 infection. In-hospital mortality was the primary outcome.

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