Verdict: NSAIDS Do NOT Worsen COVID-19 Outcomes

The verdict is in. Findings from the ISARIC CCP-UK (International Severe Acute Respiratory and Emerging Infection Consortium Clinical Characterisation Protocol United Kingdom) study, the largest of its kind, show that non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, do not result in higher rates of death or disease severity in patients hospitalised with COVID-19.

NSAIDs have been used for the treatment of acute pain and rheumatological disease for decades. When the COVID-19 pandemic started, there was significant debate about whether these drugs increase the severity of COVID-19 illness. There were also urgent calls for in-depth investigation of the use of NSAIDs in COVID-19 patients and possible discontinuation of use within this patient population. 

The ISARIC CCP-UK study collected data on the medication patients had been prescribed, were currently taking, or had taken within 14 days prior to being admitted to the hospital. The study population included patients from 255 healthcare facilities in England, Scotland, and Wales. Of the 72,179 eligible patients, 5.8% had taken NSAIDs prior to admission

Study findings provide clear evidence that the use of NSAIDs in patients with COVID-19 is safe. As per the findings of the study, a third of patients who had taken NSAIDs prior to hospital admission for COVID-19 died. However, this rate was similar in patients who had not taken NSAIDs. The study also shows that the use of NSAIDs did not increase mortality in patients with rheumatological disease. Patients who took NSAIDs were no more likely to be admitted to critical care or need invasive or non-invasive ventilation or oxygen. 

NSAIDs are one of the most commonly used drugs for managing minor aches and pains to chronic conditions such as arthritis and cardiovascular disease. Numerous people rely on these drugs to be able to conduct their daily activities. When the COVID-19 pandemic began, it was important to ensure that such commonly used drugs do not worsen outcomes in people with COVID-19. The ISRIC CCP-UK study has now clearly demonstrated that NSAIDs are safe in patients with COVID-19. This is reassuring for clinicians and for patients who can continue to use these drugs the way they did before this pandemic. 

While these findings show that NSAIDs are safe in patients with COVID-19, it is important to keep in mind that the study did not include patients with severe COVID-19 who were not hospitalised. Also, ibuprofen is commonly used in the U.K., but these findings may not be generalisable to other countries where other non-ibuprofen NSAIDs are more commonly used. Hence, further research and clinical trials may present an even better picture as to the safety of NSAIDs in patients with COVID-19. 

Source: The Lancet Rheumatology 

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