Kragholm et al., Association Between Prescribed Ibuprofen and Severe COVID‐19 Infection: A Nationwide Register‐Based Cohort.., Clinical and Translational Science, doi:10.1111/cts.12904
Abstract: Citation: Clin Transl Sci (2020) 13, 1103–1107;
doi:10.1111/cts.12904
ARTICLE
Association Between Prescribed Ibuprofen and Severe
COVID-19 Infection: A Nationwide Register-Based Cohort
Study
Kristian Kragholm1,2,*, Thomas A. Gerds3, Emil Fosbøl4, Mikkel Porsborg Andersen5, Matthew Phelps6, Jawad H.
Butt4, Lauge Østergaard4, Casper N. Bang5,6, Jannik Pallisgaard7, Gunnar Gislason6,7, Morten Schou7, Lars Køber4 and
Christian Torp-Pedersen5
Recommendations regarding ibuprofen use in relation to coronavirus disease 2019 (COVID-19) have been conflicting. We examined the risk of severe COVID-19 between ibuprofen-prescribed and non-ibuprofen patients with COVID-19 in a nationwide
register-based study of patients with COVID-19 in Denmark between the end of February 2020 and May 16, 2020. Patients
with heart failure (n = 208), < 30 years (n = 575), and prescribed other nonsteroidal anti-inflammatory drugs (n = 57) were
excluded. Patients with ibuprofen prescription claims between January 1, 2020, and before COVID-19 diagnosis or April 30,
2020 (last available prescription) were compared with patients without ibuprofen prescription claims. Outcome was a 30-day
composite of severe COVID-19 diagnosis with acute respiratory syndrome, intensive care unit admission, or death. Absolute
risks and average risk ratios comparing outcome for ibuprofen vs. non-ibuprofen patients standardized to the age, sex, and
comorbidity distribution of all patients were derived from multivariable Cox regression. Among 4,002 patients, 264 (6.6%)
had ibuprofen prescription claims before COVID-19. Age, sex, and comorbidities were comparable between the two study
groups. Standardized absolute risks of the composite outcome for ibuprofen-prescribed vs. non-ibuprofen patients were
16.3% (95% confidence interval (CI) 12.1–20.6) vs. 17.0% (95% CI 16.0–18.1), P = 0.74. The standardized average risk ratio for
ibuprofen-prescribed vs. non-ibuprofen patients was 0.96 (95% CI 0.72–1.23). Standardized absolute risks of the composite
outcome for patients with ibuprofen prescription claims > 14 days before COVID-19 vs. ≤ 14 days of COVID-19 were 17.1%
(95% CI 12.3–22.0) vs. 14.3% (95% CI 7.1–23.1). In conclusion, in this nationwide study, there was no significant association
between ibuprofen prescription claims and severe COVID-19.
Study Highlights
WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?
✔ Recommendations regarding ibuprofen use in relation
to coronavirus disease 2019 (COVID-19) have been conflicting and to date, no studies have addressed the risk of
severe COVID-19 between ibuprofen and non-ibuprofen
users.
WHAT QUESTION DID THIS STUDY ADDRESS?
✔ Is ibuprofen prescription redemption associated with
severe outcome of COVID-19?
WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?
✔ In this nationwide study, there was no significant association between ibuprofen prescription claims and severe
COVID-19.
HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?
✔ Ibuprofen prescription to patients with COVID-19
does not appear to be associated with severe COVID-19
trajectory.
The coronavirus disease 2019 (COVID-19) pandemic
caused by severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) has led to substantial changes in healthcare utilization, morbidity, intensive care resources, and
mortality.1–7 The entry point for this novel coronavirus for
its further pathogenesis in humans is thought to be through
an angiotensin-converting enzyme 2 receptor found in the
lungs,..
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