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

DOI record: { "DOI": "10.1371/journal.pone.0267462", "ISSN": [ "1932-6203" ], "URL": "http://dx.doi.org/10.1371/journal.pone.0267462", "abstract": "<jats:p>Non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are among the most-frequently 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 days (OR = 0.97, 95% CI: 0.95–1.00; OR = 1.00, 95% CI: 0.99–1.01; OR = 0.99, 95% CI: 0.98–1.01; OR = 0.99, 95% CI: 0.97–1.00; OR = 0.99, 95% CI: 0.97–1.01; OR = 0.99, 95% CI: 0.97–1.01; and OR = 1.01, 95% CI: 0.99–1.02, respectively). Although the study design cannot determine causality, the study should assure patients as it finds no association between mortality and chronic use of these medications compared with sporadic NSAID use among those infected with COVID-19.</jats:p>", "author": [ { "ORCID": "http://orcid.org/0000-0002-6401-9240", "affiliation": [], "authenticated-orcid": true, "family": "Campbell", "given": "Heather M.", "sequence": "first" }, { "affiliation": [], "family": "Murata", "given": "Allison E.", "sequence": "additional" }, { "affiliation": [], "family": "Conner", "given": "Todd A.", "sequence": "additional" }, { "affiliation": [], "family": "Fotieo", "given": "Greg", "sequence": "additional" } ], "container-title": "PLOS ONE", "container-title-short": "PLoS ONE", "content-domain": { "crossmark-restriction": false, "domain": [ "www.plosone.org" ] }, "created": { "date-parts": [ [ 2022, 5, 5 ] ], "date-time": "2022-05-05T18:01:42Z", "timestamp": 1651773702000 }, "deposited": { "date-parts": [ [ 2022, 5, 5 ] ], "date-time": "2022-05-05T18:03:06Z", "timestamp": 1651773786000 }, "editor": [ { "affiliation": [], "family": "Lazzeri", "given": "Chiara", "sequence": "first" } ], "funder": [ { "DOI": "10.13039/100012462", "doi-asserted-by": "publisher", "name": "Office of Academic Affiliations, Department of Veterans Affairs" }, { "name": "Veterans Health Administration" }, { "name": "New Mexico VA Health Care System" }, { "name": "Raymond G. Murphy VA Medical Center" }, { "name": "Cooperative Studies Program Clinical Research Pharmacy Coordinating Center" } ], "indexed": { "date-parts": [ [ 2022, 5, 6 ] ], "date-time": "2022-05-06T10:40:56Z", "timestamp": 1651833656310 }, "is-referenced-by-count": 0, "issue": "5", "issued": { "date-parts": [ [ 2022, 5, 5 ] ] }, "journal-issue": { "issue": "5", "published-online": { "date-parts": [ [ 2022, 5, 5 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/publicdomain/zero/1.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 5, 5 ] ], "date-time": "2022-05-05T00:00:00Z", "timestamp": 1651708800000 } } ], "link": [ { "URL": "https://dx.plos.org/10.1371/journal.pone.0267462", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "340", "original-title": [], "page": "e0267462", "prefix": "10.1371", "published": { "date-parts": [ [ 2022, 5, 5 ] ] }, "published-online": { "date-parts": [ [ 2022, 5, 5 ] ] }, "publisher": "Public Library of Science (PLoS)", "reference": [ { "DOI": "10.1016/S2213-2600(20)30116-8", "article-title": "Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?", "author": "L Fang", "doi-asserted-by": "crossref", "first-page": "e21", "journal-title": "Lancet Respir Med", "key": "pone.0267462.ref001", "volume": "8", "year": "2020" }, { "DOI": "10.1136/annrheumdis-2020-217598", "article-title": "Coronavirus disease 19 (Covid-19) and non-steroidal anti-inflammatory drugs (NSAID)", "author": "A Giollo", "doi-asserted-by": "crossref", "first-page": "e12", "journal-title": "Ann Rheum Dis", "key": "pone.0267462.ref002", "volume": "80", "year": "2021" }, { "DOI": "10.1016/j.joca.2013.06.026", "article-title": "The effects of nonsteroidal anti-inflammatory drugs on clinical outcomes, synovial fluid cytokine concentration and signal transduction pathways in knee osteoarthritis. 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"https://dx.plos.org/10.1371/journal.pone.0267462" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [ "Multidisciplinary" ], "subtitle": [], "title": "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", "type": "journal-article", "update-policy": "http://dx.doi.org/10.1371/journal.pone.corrections_policy", "volume": "17" }