ReviewTherapie
Non-steroidal anti-inflammatory drugs, pharmacology, and COVID-19 infection.
Review in Therapie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- NSAIDs and COVID-19: A Systematic Review and Meta-analysis.Drug safety · 2021Pooled it
- Active prescription of low-dose aspirin during or prior to hospitalization and mortality in COVID-19: A systematic review and meta-analysis of adjusted effect estimates.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Pooled it
- Derivation and validation of a nomogram for predicting nonventilator hospital-acquired pneumonia among older hospitalized patients.BMC pulmonary medicine · 2022Trial
- The effect of a single dose of flunixin meglumine on shedding of inoculated bovine herpesvirus-1 in weaned calves.Journal of veterinary internal medicine · 2026Article
- An Interpretable Deep Learning and Molecular Docking Framework for Repurposing Existing Drugs as Inhibitors of SARS-CoV-2 Main Protease.Molecules (Basel, Switzerland) · 2025Article
- The role of traditional NSAIDs and selective COX-2 inhibitors on COVID-19 outcomes: a real-world data study.Inflammopharmacology · 2024Article
- The standardization and efficacy of fermentedOpen veterinary journal · 2024Article
- Evaluating NSAIDs in SARS-CoV-2: Immunomodulatory mechanisms and future therapeutic strategies.Heliyon · 2024Review
- Article
- Emerging therapies and respiratory infections: Focus on the impact of immunosuppressants and immunotherapies.Clinical medicine (London, England) · 2024Review
- Pharmacological Proposal Approach to Managing Chronic Pain Associated with COVID-19.Biomedicines · 2023Review
- Mixed storm in SARS-CoV-2 infection: A narrative review and new term in the Covid-19 era.Immunity, inflammation and disease · 2023Review
- Serious Clinical Outcomes of COVID-19 Related to Acetaminophen or NSAIDs from a Nationwide Population-Based Cohort Study.International journal of environmental research and public health · 2023Article
- Diclofenac, ibuprofen, and paracetamol biodegradation: overconsumed non-steroidal anti-inflammatories drugs at COVID-19 pandemic.Frontiers in microbiology · 2023Review
- Evaluating the effectiveness of the Ministry of Health restriction policy on seasonal antibiotic consumption trends in Saudi Arabia, 2016-2020.Frontiers in pharmacology · 2023Article
- Causal effects and immune cell mediators between prescription analgesic use and risk of infectious diseases: a Mendelian randomization study.Frontiers in immunology · 2023Article
- The association of prior paracetamol intake with outcome of very old intensive care patients with COVID-19: results from an international prospective multicentre trial.BMC geriatrics · 2022Article
- Decrypting the cellular and molecular intricacies associated with COVID-19-induced chronic pain.Metabolic brain disease · 2022Review
- Assessment of drugs administered in the Middle East as part of the COVID-19 management protocols.Inflammopharmacology · 2022Review
- Effect of the Duration of NSAID Use on COVID-19.Medicina (Kaunas, Lithuania) · 2022Observational
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) have an optional prescription status that has resulted in frequent use, in particular for the symptomatic treatment of fever and non-rheumatic pain. In 2019, a multi-source analysis of complementary pharmacological data showed that using NSAIDs in these indications (potentially indicative of an underlying infection) increases the risk of a severe bacterial complication, in particular in the case of lung infections. First, the clinical observations of the French Pharmacovigilance Network showed that severe bacterial infections can occur even after a short NSAID treatment, and even if the NSAID is associated with an antibiotic. Second, pharmacoepidemiological studies, some of which minimized the protopathic bias, all converged and confirmed the risk. Third, experimental in vitro and in vivo animal studies suggest several biological mechanisms, which strengthens a causal link beyond the well-known risk of delaying the care of the infection (immunomodulatory effects, effects on S. pyogenes infections, and reduced antibiotics efficacy). Therefore, in case of infection, symptomatic treatment with NSAIDs for non-severe symptoms (fever, pain, or myalgia) is not to be recommended, given a range of clinical and scientific arguments supporting an increased risk of severe bacterial complication. Besides, the existence of a safer drug alternative, with paracetamol at recommended doses, makes this recommendation of precaution and common sense even more legitimate. In 2020, such recommendation is more topical than ever with the emergence of COVID-19, especially since it results in fever, headaches, muscular pain, and cough, and is further complicated with pneumopathy, and given experimental data suggesting a link between ibuprofen and the level of expression of angiotensin-converting enzyme 2.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.