Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen and relationship with mortality among United States Veterans after testing positive for COVID-19
Campbell et al.,
Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen and relationship with mortality..,
PLOS ONE, doi:10.1371/journal.pone.0267462
Retrospective 28,856 COVID-19 patients in the USA, showing no significant difference in mortality for chronic aspirin use vs. sporadic NSAID use. Since aspirin is available OTC and authors only tracked prescriptions, many patients classified as sporadic users may have been chronic users.
risk of death, 3.0% lower, OR 0.97, p = 0.06, treatment 419, control 20,311, adjusted per study, propensity score weighting, multivariable, day 60, RR approximated with OR.
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risk of death, 2.0% lower, OR 0.98, p = 0.10, treatment 419, control 20,311, adjusted per study, propensity score weighting, multivariable, day 30, RR approximated with OR.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Campbell et al., 5 May 2022, retrospective, USA, peer-reviewed, 4 authors, study period 2 March, 2020 - 14 December, 2020.
Contact:
heather.campbell@va.gov, virec@va.gov.
Abstract: PLOS ONE
RESEARCH ARTICLE
Chronic use of non-steroidal antiinflammatory drugs (NSAIDs) or
acetaminophen and relationship with
mortality among United States Veterans after
testing positive for COVID-19
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OPEN ACCESS
Citation: Campbell HM, Murata AE, Conner TA,
Fotieo G (2022) Chronic use of non-steroidal antiinflammatory drugs (NSAIDs) or acetaminophen
and relationship with mortality among United
States Veterans after testing positive for COVID-19.
PLoS ONE 17(5): e0267462. https://doi.org/
10.1371/journal.pone.0267462
Editor: Chiara Lazzeri, Azienda Ospedaliero
Universitaria Careggi, ITALY
Received: May 19, 2021
Accepted: April 8, 2022
Published: May 5, 2022
Copyright: This is an open access article, free of all
copyright, and may be freely reproduced,
distributed, transmitted, modified, built upon, or
otherwise used by anyone for any lawful purpose.
The work is made available under the Creative
Commons CC0 public domain dedication.
Data Availability Statement: Data cannot be
shared publicly because it involves sensitive
human subject information. Data may be available
for researchers who meet the criteria for access to
confidential data after evaluation from affiliated IRB
and VA Research and Development Committees.
As a VA national legal policy (VHA Directive
1605.01), VA will only share patient data if there is
a fully executed contractual agreement in place for
the specific project. A common contractual
mechanism utilized for this type of sharing is a
Heather M. Campbell ID1☯*, Allison E. Murata1☯, Todd A. Conner1, Greg Fotieo2
1 Cooperative Studies Program, Clinical Research Pharmacy Coordinating Center, US Department of
Veterans Affairs, Albuquerque, New Mexico, United States of America, 2 New Mexico VA Healthcare
System, US Department of Veterans Affairs, Albuquerque, New Mexico, United States of America
☯ These authors contributed equally to this work.
* heather.campbell@va.gov
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are among the mostfrequently used medications. Although these medications have different mechanisms of
action, they have similar indications and treatment duration has been positively correlated
with cardiovascular risk although the degree of risk varies by medication. Our objective was
to study treatment effects of chronic use of individual NSAID medications and acetaminophen on all-cause mortality among patients who tested positive for COVID-19 while
accounting for adherence. We used the VA national datasets in this retrospective cohort
study to differentiate between sporadic and chronic medication use: sporadic users filled an
NSAID within the last year, but not recently or regularly. Using established and possible risk
factors for severe COVID-19, we used propensity scores analysis to adjust for differences in
baseline characteristics between treatment groups. Then, we used multivariate logistic
regression incorporating inverse propensity score weighting to assess mortality. The cohort
consisted of 28,856 patients. Chronic use of aspirin, ibuprofen, naproxen, meloxicam, celecoxib, diclofenac or acetaminophen was not associated with significant differences in mortality at 30 days (OR = 0.98, 95% CI: 0.95–1.00; OR = 0.99, 95% CI: 0.98–1.00; OR = 1.00,
95% CI: 0.98–1.01; OR = 0.99, 95% CI: 0.98–1.00; OR = 1.00, 95% CI: 0.98–1.01; OR =
0.99, 95% CI: 0.97–1.01; and OR = 1.00, 95% CI: 0.99–1.02, respectively) nor at 60..
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