September 8, 2020

expert reaction to study of NSAIDs and severity of COVID

A study, published in PLOS Medicine, looked at Non-steroidal anti-inflammatory drugs (NSAIDs) and severity of COVID-19.

Dr Rupert Payne, Consultant Senior Lecturer in Primary Care at the University of Bristol, said:

“Increasing numbers of COVID19 cases are being seen in Europe in recent weeks, particularly in younger groups. These individuals seem at lower risk of severe disease, and this research provides reassurance that simple, over-the-counter NSAID treatment can be used relatively safely to manage patients.

“The health data available in Denmark is extremely good, so is ideal for doing this sort of research. A further strength is that, unlike many other countries, NSAIDs are generally only available via prescription, so most patients using these medications would have been picked up by the analysis. This provides reassurance that the findings are reliable.

“However, there is a possibility that doctors prescribing NSAIDs were more cautious about their use in sicker, older patients – particularly early on in the pandemic, when there was more uncertainty about their safety. This could mean that the reason NSAIDs appear safe is simply because they were only being used in people at less risk of complications.

“The researchers have done a good job of trying to take some of these complicating factors into account, and on balance I think the results are fairly reassuring. However, the only way we would be able to know for certain would be to conduct a proper randomised clinical trial, and this would be challenging to do. Regardless of these uncertainties, NSAIDs do have fairly well-established side effects, such as kidney damage and causing stomach ulcers, so my advice would be that it is reasonable to use these medicines to treat the symptoms of mild COVID19, but to minimise the dose and duration of treatment where possible.”

Professor Gino Martini, Chief Scientist at the Royal Pharmaceutical Society, said:

“At the start of the pandemic there were research studies that indicated that there could be issues in administering ibuprofen to COVID 19 patients.  It was right that because of the uncertainty involved, a cautious approach to using ibuprofen was taken as evidence was collated and reviewed. This current study indicates that ibuprofen is safe to use if you have COVID-19 and if you’ve got any doubts, speak to your pharmacist who can advise you further.”

‘Adverse outcomes and mortality in users of non-steroidal anti-inflammatory drugs who tested positive for SARS-CoV-2: A Danish nationwide cohort study’ by Lars Christian Lund et al. was published in PLOS Medicine at 7pm UK TIME on Tuesday 8 September 2020.

DOI: https://doi.org/10.1371/journal.pmed.1003308

Declared interests

None received.