Bordeaux PharmacoEpi, Inserm CIC 1401, University of Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France.
Drug Saf. 2021 Sep;44(9):929-938. doi: 10.1007/s40264-021-01089-5. Epub 2021 Aug 2.
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been discouraged for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, fearing that they could increase the risk of infection or the severity of SARS-CoV-2.
Original studies providing information on exposure to NSAIDs and coronavirus disease 2019 (COVID-19) outcomes were retrieved and were included in a descriptive analysis and a meta-analysis with Cochrane Revue Manager (REVMAN 5.4), using inverse variance odds ratio (OR) with random- or fixed-effects models.
Of 92,853 papers mentioning COVID-19, 266 mentioned NSAIDs and 61 mentioned ibuprofen; 19 papers had analysable data. Three papers described NSAID exposure and the risk of SARS-CoV-2 positivity, five papers described the risk of hospital admission in positive patients, 10 papers described death, and six papers described severe composite outcomes. Five papers studied exposure to ibuprofen and death. Using random-effects models, there was no excess risk of SARS-CoV-2 positivity (OR 0.86, 95% confidence interval [CI] 0.71-1.05). In SARS-CoV-2-positive patients, exposure to NSAIDs was not associated with excess risk of hospital admission (OR 0.90, 95% CI 0.80-1.17), death (OR 0.88, 95% CI 0.80-0.98), or severe outcomes (OR 1.14, 95% CI 0.90-1.44). With ibuprofen, there was no increased risk of death (OR 0.94, 95% CI 0.78-1.13). Using a fixed-effect model did not modify the results, nor did the sensitivity analyses.
The theoretical risks of NSAIDs or ibuprofen in SARS-CoV-2 infection are not confirmed by observational data.
非甾体抗炎药（NSAIDs）已被劝阻用于治疗严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染，因为担心它们会增加感染风险或 SARS-CoV-2 的严重程度。
检索了提供 NSAIDs 暴露与 2019 年冠状病毒病（COVID-19）结局信息的原始研究，并进行了描述性分析和荟萃分析，使用 Cochrane Revue Manager（REVMAN 5.4）中的逆方差比值比（OR），使用随机或固定效应模型。
在提到 COVID-19 的 92853 篇论文中，有 266 篇提到 NSAIDs，61 篇提到布洛芬；有 19 篇论文有可分析的数据。三篇论文描述了 NSAID 暴露与 SARS-CoV-2 阳性的风险，五篇论文描述了阳性患者住院的风险，十篇论文描述了死亡，六篇论文描述了严重复合结局。五篇论文研究了布洛芬暴露与死亡的关系。使用随机效应模型，SARS-CoV-2 阳性患者 NSAID 暴露与住院风险增加无关（OR 0.86，95%置信区间[CI] 0.71-1.05）。在 SARS-CoV-2 阳性患者中，NSAIDs 暴露与死亡（OR 0.88，95%CI 0.80-0.98）或严重结局（OR 1.14，95%CI 0.90-1.44）风险增加无关。使用布洛芬时，死亡风险没有增加（OR 0.94，95%CI 0.78-1.13）。固定效应模型不会改变结果，敏感性分析也不会改变结果。
观察数据并未证实 NSAIDs 或布洛芬在 SARS-CoV-2 感染中的理论风险。
