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0 0.5 1 1.5 2+ Mortality -71% Improvement Relative Risk Ventilation -14% ICU admission 40% Oxygen therapy -9% Acetaminophen for COVID-19  Kim et al.  Prophylaxis Is prophylaxis with acetaminophen beneficial for COVID-19? PSM retrospective 324 patients in South Korea Study compares with NSAIDs, results vs. placebo may differ Higher mortality with acetaminophen (not stat. sig., p=0.34) Kim et al., Int. J. Environmental Rese.., Feb 2023 Favors acetaminophen Favors NSAIDs

Serious Clinical Outcomes of COVID-19 Related to Acetaminophen or NSAIDs from a Nationwide Population-Based Cohort Study

Kim et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph20053832
Feb 2023  
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PSM retrospective in South Korea, showing no significant differences in outcomes with acetaminophen use vs. NSAID use. Adherence and dosage are unknown. Acetaminophen is also known as paracetamol, Tylenol, Panadol, Calpol, Tempra, Calprofen, Doliprane, Efferalgan, Grippostad C, Dolo, Acamol, Fevadol, Crocin, and Perfalgan.
risk of death, 71.4% higher, RR 1.71, p = 0.34, treatment 12 of 162 (7.4%), control 7 of 162 (4.3%), propensity score matching.
risk of mechanical ventilation, 14.3% higher, RR 1.14, p = 1.00, treatment 8 of 162 (4.9%), control 7 of 162 (4.3%), propensity score matching.
risk of ICU admission, 40.0% lower, RR 0.60, p = 0.72, treatment 3 of 162 (1.9%), control 5 of 162 (3.1%), NNT 81, propensity score matching.
risk of oxygen therapy, 9.1% higher, RR 1.09, p = 0.87, treatment 24 of 162 (14.8%), control 22 of 162 (13.6%), propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kim et al., 21 Feb 2023, retrospective, South Korea, peer-reviewed, mean age 55.8, 4 authors, this trial compares with another treatment - results may be better when compared to placebo.
Contact: (corresponding author).
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Serious Clinical Outcomes of COVID-19 Related to Acetaminophen or NSAIDs from a Nationwide Population-Based Cohort Study
Jin-Woo Kim, Siyeong Yoon, Jongheon Lee, Soonchul Lee
International Journal of Environmental Research and Public Health, doi:10.3390/ijerph20053832
Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) have been widely prescribed to infected patients; however, the safety of them has not been investigated in patients with serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Our objective was to evaluate the association between the previous use of acetaminophen or NSAIDs and the clinical outcomes of SARS-CoV-2 infection. A nationwide population-based cohort study was conducted using the Korean Health Insurance Review and Assessment Database through propensity score matching (PSM). A total of 25,739 patients aged 20 years and older who tested for SARS-CoV-2 were included from 1 January 2015 to 15 May 2020. The primary endpoint was a positive result for a SARS-CoV-2 test, and the secondary endpoint was serious clinical outcomes of SARS-CoV-2 infection, such as conventional oxygen therapy, admission to the intensive care unit, need for invasive ventilation care, or death. Of 1058 patients, after propensity score matching, 176 acetaminophen users and 162 NSAIDs users were diagnosed with coronavirus disease 2019. After PSM, 162 paired data sets were generated, and the clinical outcomes of the acetaminophen group were not significantly different from those of the NSAIDs group. This suggests that acetaminophen and NSAIDs can be used safely to control symptoms in patients suspected of having SARS-CoV-2.
Author Contributions: Conceptualization, J.-W.K. and S.L.; methodology, S.Y.; software S.Y.; validation, S.L.; formal analysis, S.Y.; investigation, J.-W.K. and J.L.; resources, S.L.; data curation, S.Y.; writing-original draft preparation, J.-W.K. and S.Y.; writing-review and editing, S.L.; visualization, J.L.; supervision, S.L.; project administration, S.L. All authors have read and agreed to the published version of the manuscript. Informed Consent Statement: Informed consent was obtained from the patients to publish this paper. Conflicts of Interest: The authors declare no conflict of interest.
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Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, 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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