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All Studies   Meta Analysis    Recent:   

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., PLOS ONE, doi:10.1371/journal.pone.0267462
May 2022  
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Mortality, day 60 -1% Improvement Relative Risk Mortality, day 30 0% Acetaminophen  Campbell et al.  Prophylaxis Is prophylaxis with acetaminophen beneficial for COVID-19? Retrospective 22,385 patients in the USA (March - December 2020) No significant difference in mortality c19early.org Campbell et al., PLOS ONE, May 2022 Favorsacetaminophen Favorscontrol 0 0.5 1 1.5 2+
2nd treatment shown to increase risk in November 2020
 
*, now with p = 0.00000029 from 27 studies, but still recommended in 64 countries.
* From meta analysis with ≥3 studies.
4,800+ studies for 98 treatments. c19early.org
Retrospective 28,856 COVID-19 patients in the USA, showing no significant difference in mortality for chronic acetaminophen use vs. sporadic NSAID use. Since acetaminophen is available OTC and authors only tracked prescriptions, many patients classified as sporadic users may have been chronic users.
Acetaminophen is also known as paracetamol, Tylenol, Panadol, Calpol, Tempra, Calprofen, Doliprane, Efferalgan, Grippostad C, Dolo, Acamol, Fevadol, Crocin, and Perfalgan.
Study covers acetaminophen, ibuprofen, and aspirin.
risk of death, 1.0% higher, OR 1.01, p = 0.43, treatment 2,074, control 20,311, adjusted per study, propensity score weighting, multivariable, day 60, RR approximated with OR.
risk of death, no change, OR 1.00, p = 0.86, treatment 2,074, control 20,311, adjusted per study, propensity score weighting, multivariable, day 30, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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.
This PaperAcetaminophenAll
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
Heather M Campbell, Allison E Murata, Todd A Conner, Greg Fotieo
PLOS ONE, doi:10.1371/journal.pone.0267462
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 (
take these medications chronically is no different than patients who sporadically used NSAIDs. This information can also be used by clinicians caring for patients as they make clinical treatment decisions based on their risk assessment. Our attempt to address this was by controlling the month or season in which patients tested positive: with an unadjusted OR = 0.90 and OR = 0.91 for 30-day and 60-day mortality, respectively, month did not meet the criteria for a moderate association to be included in the final propensity score-adjusted model. With season having OR = 0.66 and OR = 0.68 for 30-and 60-day mortality, respectively, it also did not meet the criteria of OR = 0.50 to be included.
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A randomized open label trial', 'volume': '21', 'author': 'L Gallelli', 'year': '2013', 'journal-title': 'Osteoarthritis Cartilage'}, { 'key': 'pone.0267462.ref004', 'doi-asserted-by': 'crossref', 'first-page': '720', 'DOI': '10.1016/j.jcf.2015.03.007', 'article-title': 'Use of ibuprofen to assess inflammatory biomarkers in induced sputum: ' 'Implications for clinical trials in cystic fibrosis', 'volume': '14', 'author': 'JF Chmiel', 'year': '2015', 'journal-title': 'J Cyst Fibros'}, { 'key': 'pone.0267462.ref005', 'doi-asserted-by': 'crossref', 'first-page': '69', 'DOI': '10.1136/dtb.2020.000021', 'article-title': 'EMA advice on the use of NSAIDs for Covid-19', 'volume': '58', 'year': '2020', 'journal-title': 'Drug Ther Bull'}, { 'key': 'pone.0267462.ref006', 'volume-title': 'Drug Safety and Availability [Internet]', 'author': 'United States Food and Drug Administration'}, { 'key': 'pone.0267462.ref007', 'volume-title': 'COVID-19 [Internet].', 'author': 'United States Department of Health and Human Services', 'year': '2020'}, { 'key': 'pone.0267462.ref008', 'volume-title': 'COVID-19 [Internet].', 'author': 'United States Department of Health and Human Services'}, { 'key': 'pone.0267462.ref009', 'doi-asserted-by': 'crossref', 'first-page': '769', 'DOI': '10.1016/S0140-6736(13)60900-9', 'article-title': 'Vascular and upper gastrointestinal effects of non-steroidal ' 'anti-inflammatory drugs: meta-analyses of individual participant data ' 'from randomised trials', 'volume': '382', 'author': 'Coxib and traditional NSAID Trialists’ (CNT) Collaboration', 'year': '2013', 'journal-title': 'Lancet'}, { 'key': 'pone.0267462.ref010', 'doi-asserted-by': 'crossref', 'first-page': '1657', 'DOI': '10.1093/eurheartj/ehl053', 'article-title': 'NSAID use and the risk of hospitalization for first myocardial ' 'infarction in the general population: a nationwide case-control study ' 'from Finland', 'volume': '27', 'author': 'A Helin-Salmivaara', 'year': '2006', 'journal-title': 'Eur Heart J'}, { 'key': 'pone.0267462.ref011', 'doi-asserted-by': 'crossref', 'first-page': 'd3450', 'DOI': '10.1136/bmj.d3450', 'article-title': 'Non-steroidal anti-inflammatory drug use and risk of atrial ' 'fibrillation or flutter: population based case-control study', 'volume': '343', 'author': 'M Schmidt', 'year': '2011', 'journal-title': 'BMJ'}, { 'key': 'pone.0267462.ref012', 'doi-asserted-by': 'crossref', 'first-page': '1950', 'DOI': '10.1161/CIRCULATIONAHA.105.602425', 'article-title': 'Use of first- and second-generation cyclooxygenase-2-selective ' 'nonsteroidal antiinflammatory drugs and risk of acute myocardial ' 'infarction', 'volume': '113', 'author': 'F Andersohn', 'year': '2006', 'journal-title': 'Circulation'}, { 'key': 'pone.0267462.ref013', 'doi-asserted-by': 'crossref', 'first-page': '1578', 'DOI': '10.1161/CIRCULATIONAHA.105.595793', 'article-title': 'Nonsteroidal antiinflammatory drugs, acetaminophen, and the risk of ' 'cardiovascular events', 'volume': '113', 'author': 'AT Chan', 'year': '2006', 'journal-title': 'Circulation'}, {'key': 'pone.0267462.ref014', 'first-page': '1', 'author': 'N. 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'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 5, 5]], 'date-time': '2022-05-05T18:03:06Z', 'timestamp': 1651773786000}, 'score': 1, 'resource': {'primary': {'URL': 'https://dx.plos.org/10.1371/journal.pone.0267462'}}, 'subtitle': [], 'editor': [{'given': 'Chiara', 'family': 'Lazzeri', 'sequence': 'first', 'affiliation': []}], 'short-title': [], 'issued': {'date-parts': [[2022, 5, 5]]}, 'references-count': 41, 'journal-issue': {'issue': '5', 'published-online': {'date-parts': [[2022, 5, 5]]}}, 'URL': 'http://dx.doi.org/10.1371/journal.pone.0267462', 'relation': {}, 'ISSN': ['1932-6203'], 'subject': ['Multidisciplinary'], 'container-title-short': 'PLoS ONE', 'published': {'date-parts': [[2022, 5, 5]]}}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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