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0 0.5 1 1.5 2+ Mortality 2% Improvement Relative Risk Acetaminophen for COVID-19  Oh et al.  Prophylaxis Is prophylaxis with acetaminophen beneficial for COVID-19? Retrospective 7,713 patients in South Korea (Jan - Jun 2020) No significant difference in mortality c19early.org Oh et al., Int. J. Environmental Resea.., Jun 2021 Favors acetaminophen Favors control

Musculoskeletal Disorders, Pain Medication, and in-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study

Oh et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18136804
Jun 2021  
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1st treatment shown to increase risk in November 2020
 
*, now known with p = 0.00000029 from 27 studies, but still recommended in 46 countries.
* From meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 7,713 COVID-19 patients in Korea, showing no significant difference in mortality with paracetamol use.
Paracetamol is also known as acetaminophen, Tylenol, Panadol, Calpol, Tempra, Calprofen, Doliprane, Efferalgan, Grippostad C, Dolo, Acamol, Fevadol, Crocin, and Perfalgan.
risk of death, 1.9% lower, RR 0.98, p = 0.97, treatment 58, control 7,655, adjusted per study, odds ratio converted to relative risk, multivariable, control prevalance approximated with overall prevalence.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Oh et al., 24 Jun 2021, retrospective, South Korea, peer-reviewed, 5 authors, study period 1 January, 2020 - 4 June, 2020. Contact: uchic@ncc.re.kr (corresponding author), airohtak@hotmail.com, songoficu@outlook.kr, leejoon.com@gmail.com, ytjeon@snubh.org.
This PaperAcetaminophenAll
Musculoskeletal Disorders, Pain Medication, and in-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study
Tak-Kyu Oh, In-Ae Song, Joon Lee, Woosik Eom, Young-Tae Jeon
International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18136804
We aimed to investigate whether comorbid musculoskeletal disorders (MSD)s and pain medication use was associated with in-hospital mortality among patients with coronavirus disease 2019 . Adult patients (≥20 years old) with a positive COVID-19 diagnosis until 5 June 2020 were included in this study, based on the National Health Insurance COVID-19 database in South Korea. MSDs included osteoarthritis, neck pain, lower back pain, rheumatoid arthritis, and others, while pain medication included paracetamol, gabapentin, pregabalin, glucocorticoid, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids (strong and weak opioids), and benzodiazepine. Primary endpoint was in-hospital mortality. A total of 7713 patients with COVID-19 were included, and in-hospital mortality was observed in 248 (3.2%) patients. In multivariate logistic regression analysis, no MSDs (p > 0.05) were significantly associated with in-hospital mortality. However, in-hospital mortality was 12.73 times higher in users of strong opioids (odds ratio: 12.73, 95% confidence interval: 2.44-16.64; p = 0.002), while use of paracetamol (p = 0.973), gabapentin or pregabalin (p = 0.424), glucocorticoid (p = 0.673), NSAIDs (p = 0.979), weak opioids (p = 0.876), and benzodiazepine (p = 0.324) was not associated with in-hospital mortality. In South Korea, underlying MSDs were not associated with increased in-hospital mortality among patients with COVID-19. However, use of strong opioids was significantly associated with increased in-hospital mortality among the patients.
Supplementary Materials: The following are available online at https://www.mdpi.com/article/10 .3390/ijerph18136804/s1, Table S1 : ICD-10 codes and Table S2 : The ICD-10 codes used by comorbidity to compute the Charlson comorbidity index. Informed Consent Statement: Informed consent was waived by the IRB, as the analyses were performed retrospectively using anonymized data derived from the South Korean NHIS database. Conflicts of Interest: The authors declare no conflict of interest.
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