传统非甾体抗炎药和选择性 COX-2 抑制剂对 COVID-19 结局的作用:一项真实世界数据研究。

The role of traditional NSAIDs and selective COX-2 inhibitors on COVID-19 outcomes: a real-world data study.

机构信息

Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Institute of Health Research of Santiago de Compostela de Compostela, Santiago de Compostela, Spain.

WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain.

出版信息

Inflammopharmacology. 2024 Dec;32(6):3697-3705. doi: 10.1007/s10787-024-01568-y. Epub 2024 Sep 23.

Abstract

The relation between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and severity of COVID-19 has been the subject to debate since the outbreak of the pandemic. Despite speculations about the possible harmful or protective effects, the position currently most supported by the scientific community is that there is no association between use of NSAIDs and COVID-19 outcomes. With the aim of contributing to increase the body of evidence on this issue, we conducted a case-control study using real-world data to investigate the association between prior use of NSAIDs, by active ingredient and type (traditional NSAIDs and selective COX-2 inhibitors), and important COVID-19-related outcomes, including susceptibility, PCR + patient progression, and hospitalisation. Our findings suggest that, in general, the use of traditional NSAIDs is not associated with any adverse COVID-19 outcome. However, we observed a possible association between diclofenac and a higher risk of PCR + patient progression. Our results also suggest that selective COX-2 inhibitors might be related with a reduction in the risk of PCR + patient progression. These results suggest that, with the possible exception of diclofenac, the use of NSAIDs should not be advised against for relief of symptoms in patients with COVID-19. In addition, they support the importance of continue to investigate the treatment potential of selective COX-2 inhibitors in the management of COVID-19, something that could have significant implications for the treatment of this disease and other viral infections.

摘要

自疫情爆发以来,非甾体抗炎药(NSAIDs)的使用与 COVID-19 严重程度之间的关系一直存在争议。尽管人们对其可能产生的有害或保护作用存在各种猜测,但目前科学界最支持的观点是,NSAIDs 的使用与 COVID-19 结局之间没有关联。为了增加关于这个问题的证据,我们进行了一项病例对照研究,使用真实世界的数据来调查 NSAIDs 的使用(按活性成分和类型,包括传统 NSAIDs 和选择性 COX-2 抑制剂)与重要的 COVID-19 相关结局(包括易感性、PCR 阳性患者进展和住院)之间的关联。我们的研究结果表明,一般来说,传统 NSAIDs 的使用与任何不良 COVID-19 结局无关。然而,我们观察到双氯芬酸与 PCR 阳性患者进展风险增加之间可能存在关联。我们的结果还表明,选择性 COX-2 抑制剂可能与 PCR 阳性患者进展风险降低相关。这些结果表明,除了双氯芬酸以外,NSAIDs 的使用不应被劝阻,以缓解 COVID-19 患者的症状。此外,它们支持继续研究选择性 COX-2 抑制剂在 COVID-19 治疗中的潜在治疗作用,这对于治疗这种疾病和其他病毒感染可能具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c03/11550288/69662398feee/10787_2024_1568_Fig1_HTML.jpg

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