About: Association between NSAIDs use and adverse clinical outcomes among adults hospitalised with COVID-19 in South Korea: A nationwide study

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About: Association between NSAIDs use and adverse clinical outcomes among adults hospitalised with COVID-19 in South Korea: A nationwide study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Association between NSAIDs use and adverse clinical outcomes among adults hospitalised with COVID-19 in South Korea: A nationwide study
Creator	Shin, Hyun Choe, Young Shin, Ju-Young Eol, Han Filion, Kristian Lee, Hyesung Mph, Jeong
source	MedRxiv
abstract	BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) may exacerbate COVID-19 and worsen associated outcomes by upregulating the enzyme that SARS-CoV-2 binds to enter cells. However, to our knowledge, no study has examined the association between NSAID use and the risk of COVID-19-related outcomes among hospitalised patients. METHODS: We conducted a population-based cohort study using South Korea nationwide healthcare database, which contains data of all subjects who received a test for COVID-19 (n=69,793) as of April 8, 2020. We identified a cohort of adults hospitalised with COVID-19, where cohort entry was the date of hospitalisation. NSAIDs users were those prescribed NSAIDs while hospitalised and non-users were those not prescribed NSAIDs. Our primary outcome was a composite of death, intensive care unit admission, mechanical ventilation use, and sepsis; secondary outcome was cardiovascular or renal complications. We conducted logistic regression analysis to estimate adjusted odds ratio (aOR) with 95% confidence intervals (CI) for the risk of these outcomes associated with NSAIDs users versus non-users, using propensity score-inverse probability of treatment weighting to minimize potential confounding. In sensitivity analyses, we compared NSAIDs to paracetamol (acetaminophen) to minimize confounding by indication. FINDINGS: Of 1,824 adults hospitalised with COVID-19 (mean age 44.7 years; female 59%), 285 were NSAIDs users and 1,539 were non-users. Compared with non-users, NSAIDs users were associated with increased risks of the primary composite outcome (aOR 1.54, 95% CI 1.11-2.15) and cardiovascular or renal complications (aOR 2.64, 95% CI 1.67-4.16). The association with primary outcome remained consistent when comparing NSAIDs to paracetamol (aOR 1.31, 95% CI 0.89-1.95). INTERPRETATION: Use of NSAIDs, compared with non-use, is associated with worse outcomes among hospitalised COVID-19 patients. While awaiting the results of confirmatory studies, we suggest NSAIDs be used with caution as the harms associated with their use may outweigh their benefits in this population.
has issue date	2020-06-02(xsd:dateTime)
bibo:doi	10.1101/2020.06.01.20119768
has license	medrxiv
sha1sum (hex)	98d6d4361313fb52d3611cd4940ff2c85b08ab2c
schema:url	https://doi.org/10.1101/2020.06.01.20119768
resource representing a document's title	Association between NSAIDs use and adverse clinical outcomes among adults hospitalised with COVID-19 in South Korea: A nationwide study
resource representing a document's body	covid:98d6d4361313fb52d3611cd4940ff2c85b08ab2c#body_text
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