(2021) Nonsteroidal antiinflammatory drugs and susceptibility to COVID‐19. Arthritis & Rheumatology, 73 (5). pp. 731-739. doi:10.1002/art.41593 ISSN 2326-5205.

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Abstract

Objective
To identify whether active use of nonsteroidal antiinflammatory drugs (NSAIDs) increases susceptibility to developing suspected or confirmed coronavirus disease 2019 (COVID-19) compared to the use of other common analgesics.

Methods
We performed a propensity score–matched cohort study with active comparators, using a large UK primary care data set. The cohort consisted of adult patients age ≥18 years with osteoarthritis (OA) who were followed up from January 30 to July 31, 2020. Patients prescribed an NSAID (excluding topical preparations) were compared to those prescribed either co-codamol (paracetamol and codeine) or co-dydramol (paracetamol and dihydrocodeine). A total of 13,202 patients prescribed NSAIDs were identified, compared to 12,457 patients prescribed the comparator drugs. The primary outcome measure was the documentation of suspected or confirmed COVID-19, and the secondary outcome measure was all-cause mortality.

Results
During follow-up, the incidence rates of suspected/confirmed COVID-19 were 15.4 and 19.9 per 1,000 person-years in the NSAID-exposed group and comparator group, respectively. Adjusted hazard ratios for suspected or confirmed COVID-19 among the unmatched and propensity score–matched OA cohorts, using data from clinical consultations in primary care settings, were 0.82 (95% confidence interval [95% CI] 0.62–1.10) and 0.79 (95% CI 0.57–1.11), respectively, and adjusted hazard ratios for the risk of all-cause mortality were 0.97 (95% CI 0.75–1.27) and 0.85 (95% CI 0.61–1.20), respectively. There was no effect modification by age or sex.

Conclusion
No increase in the risk of suspected or confirmed COVID-19 or mortality was observed among patients with OA in a primary care setting who were prescribed NSAIDs as compared to those who received comparator drugs. These results are reassuring and suggest that in the absence of acute illness, NSAIDs can be safely prescribed during the ongoing pandemic.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RM Therapeutics. Pharmacology
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor:	Library Publications Router
Library of Congress Subject Headings (LCSH):	COVID-19 (Disease) -- Susceptibility, Nonsteroidal anti-inflammatory agents
Journal or Publication Title:	Arthritis & Rheumatology
Publisher:	Wiley
ISSN:	2326-5205
Official Date:	May 2021
Dates:	Date Event May 2021 Published 13 November 2020 Available 10 November 2020 Accepted
Volume:	73
Number:	5
Page Range:	pp. 731-739
DOI:	10.1002/art.41593
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	10 March 2022
Date of first compliant Open Access:	10 March 2022
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED [MRC] Medical Research Council http://dx.doi.org/10.13039/501100000265 UNSPECIFIED [NIHR] National Institute for Health Research http://dx.doi.org/10.13039/501100000272 UNSPECIFIED Health Data Research UK https://www.hdruk.ac.uk/
Is Part Of:	1

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