Nearly all studies of COVID-19 patients show no association between worsening conditions and use of NSAIDs

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The vast majority of patients from observational studies diagnosed with COVID-19 show no association between the use of nonsteroidal anti-inflammatory medicines (NSAIDs), including ibuprofen, and worsening clinical outcomes. Consumers practicing self-care should follow recommendations from the World Health Organization (WHO) and local health care authorities, and be weary of speculative media reports. Nearly all studies have reported either no association or insignificant results.

A study based on a large sample of 1305 Michigan (United States) patients concludes: “Advanced age and an increasing number of comorbidities are independent predictors of inhospital mortality for COVID19 patients. NSAIDs and ACEI/ARB use prior to admission is not associated with renal failure or increased mortality (Imam et al., 2020).” [1]

“The use of NSAIDs was not associated with 30-day mortality, hospitalisation, ICU-admission, mechanical ventilation or renal replacement therapy in Danish individuals tested positive for SARS-CoV-2,” according to Danish research which presents similar conclusions (Lund et al., 2020).[2]

Another study based on a sample of 403 confirmed COVID-19 cases, with a median age of 45 years published by Clinical Microbiology and Infection concludes that: “In this cohort of COVID-19 patients, Ibuprofen use was not associated with worse clinical outcomes, compared to paracetamol or no antipyretic (Rinott at al., 2020).” [3]

“Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation,” finds an article from the Annals of the Rheumatic Diseases (Gianfrancesco et al., 2020). [4]

Both the World Health Organization (WHO) and the European Medicines Agency (EMA) have stated that there is no evidence of a connection between NSAIDs and worsening symptoms of COVID-19. “At present there is no evidence of severe adverse events, acute health care utilization, long-term survival, or quality of life in patients with COVID-19, as a result of the use of NSAIDs,” WHO says in a scientific brief. [5] 

As such, both WHO and EMA continue to advise patients and healthcare professionals to consider all available treatment options including paracetamol and NSAIDs, as per the approved product information.

Self-care is crucial in decreasing the burden on health-care systems, particularly during this time of crisis.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public



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[1] Imam et al. (2020). Older Age and Comorbidity Are Independent Mortality Predictors in a Large Cohort of 1305 COVID-19 Patients in Michigan, United States. J Intern Med. doi: 10.1111/joim.13119

[2] Lund et al. (2020). Adverse Outcomes and Mortality in Users of Non-Steroidal Anti-Inflammatory Drugs tested positive for SARS-CoV-2: A Danish Nationwide Cohort Study. medRxiv. doi: https://doi.org/10.1101/2020.06.08.20115683

[3] Rinott at al. (2020). Ibuprofen use and clinical outcomes in COVID-19 patients. Clinical Microbiology and Infection. doi: https://doi.org/10.1016/j.cmi.2020.06.003

[4] Gianfrancesco et al. (2020). Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Annals of the Rheumatic Diseases. doi: http://dx.doi.org/10.1136/annrheumdis-2020-217871

[5] WHO (2020). The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19