Impact of domiciliary administration of NSAIDs on COVID-19 hospital outcomes: an unCoVer analysis

Elena Salvador; Cristina Mazzi; Nicoletta De Santis; Giulia Bertoli; Antonija Jonjić; Miran Coklo; Marek Majdan; José L Peñalvo; Dora Buonfrate

doi:10.3389/fphar.2023.1252800

Impact of domiciliary administration of NSAIDs on COVID-19 hospital outcomes: an unCoVer analysis

Front Pharmacol. 2023 Oct 9:14:1252800. doi: 10.3389/fphar.2023.1252800. eCollection 2023.

Authors

Affiliations

¹ Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
² Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
³ Centre for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia.
⁴ Institute for Global Health and Epidemiology, Trnava University, Trnava, Slovakia.
⁵ Unit of Non-Communicable Diseases, Institute of Tropical Medicine, Antwerp, Belgium.
⁶ Global Health Institute, University of Antwerp, Antwerp, Belgium.

^# Contributed equally.

Abstract

Background: Effective domiciliary treatment can be useful in the early phase of COVID-19 to limit disease progression, and pressure on hospitals. There are discrepant data on the use of non-steroidal anti-inflammatory drugs (NSAIDs). Aim of this study is to evaluate whether the clinical outcome of patients who were hospitalized for COVID-19 is influenced by domiciliary treatment with NSAIDs. Secondary objective was to explore the association between other patient characteristics/therapies and outcome. Methods: A large dataset of COVID-19 patients was created in the context of a European Union-funded project (unCoVer). The primary outcome was explored using a study level random effects meta-analysis for binary (multivariate logistic regression models) outcomes adjusted for selected factors, including demographics and other comorbidities. Results: 218 out of 1,144 patients reported use of NSAIDs before admission. No association between NSAIDs use and clinical outcome was found (unadj. OR: 0.96, 95%CI: 0.68-1.38). The model showed an independent upward risk of death with increasing age (OR 1.06; 95% CI 1.05-1.07) and male sex (1.36; 95% CI 1.04-1.76). Conclusion: In our study, the domiciliary use of NSAIDs did not show association with clinical outcome in patients hospitalized with COVID-19. Older ages and male sex were associated to an increased risk of death.

Keywords: COVID-19; NSAIDs; SARS-CoV-2; outcome; treatment; uncover.

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. UnCoVer project is funded by the European Union’s Horizon 2020 Research and Innovation Programme (Grant Agreement No 101016216). IRCCS Sacro Cuore Don Calabria hospital also received funding from the Italian ministry of Health–Ricerca corrente L1P8.