Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova.
IRCCS Ospedale Policlinico San Martino, Genova.
Curr Opin Infect Dis. 2024 Aug 1;37(4):304-311. doi: 10.1097/QCO.0000000000001024. Epub 2024 May 23.
To review the rationale for and the potential clinical benefits of an early approach to viral acute respiratory infections with NSAIDs to switch off the inflammatory cascade before the inflammatory process becomes complicated.
It has been shown that in COVID-19 as in other viral respiratory infections proinflammatory cytokines are produced, which are responsible of respiratory and systemic symptoms. There have been concerns that NSAIDs could increase susceptibility to SARS-CoV-2 infection or aggravate COVID-19. However, recent articles reviewing experimental research, observational clinical studies, randomized clinical trials, and meta-analyses conclude that there is no basis to limit the use of NSAIDs, which may instead represent effective self-care measures to control symptoms.
The inflammatory response plays a pivotal role in the early phase of acute respiratory tract infections (ARTIs); a correct diagnosis of the cause and a prompt therapeutic approach with NSAIDs may have the potential to control the pathophysiological mechanisms that can complicate the condition, while reducing symptoms to the benefit of the patient. A timely treatment with NSAIDs may limit the inappropriate use of other categories of drugs, such as antibiotics, which are useless when viral cause is confirmed and whose inappropriate use is responsible for the development of resistance.
探讨在病毒急性呼吸道感染（ARTI）早期应用 NSAIDs 阻断炎症级联反应的合理性及潜在临床获益，以防止炎症过程复杂化。
已有研究表明，COVID-19 及其他病毒性呼吸道感染中会产生促炎细胞因子，引起呼吸道和全身症状。曾有观点认为 NSAIDs 可能会增加 SARS-CoV-2 感染易感性或加重 COVID-19，但最近的综述文章，包括实验研究、观察性临床研究、随机临床试验和荟萃分析均表明，没有理由限制 NSAIDs 的使用，实际上 NSAIDs 可能是控制症状的有效自我保健措施。
炎症反应在急性呼吸道感染（ARTI）的早期阶段起着关键作用；正确诊断病因并及时应用 NSAIDs 可能具有控制病情恶化的病理生理机制的潜力，同时减轻症状，使患者受益。及时应用 NSAIDs 可能限制了其他类药物（如抗生素）的不恰当使用，因为在病毒感染明确的情况下抗生素是无效的，而抗生素的不恰当使用会导致耐药性的产生。
