Ibuprofen use and clinical outcomes in COVID-19 patients
Retrospective 89 febrile COVID-19 patients in Israel taking paracetamol and 49 taking ibuprofen, showing higher need for respiratory support with paracetamol.
risk of death, 472.9% higher, RR 5.73, p = 0.30, treatment 3 of 85 (3.5%), control 0 of 49 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).
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risk of oxygen therapy, 534.1% higher, RR 6.34, p = 0.06, treatment 11 of 85 (12.9%), control 1 of 49 (2.0%).
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Rinott et al., 30 Sep 2020, retrospective, Israel, peer-reviewed, median age 45.0, 5 authors, study period 15 March, 2020 - 15 April, 2020, this trial compares with another treatment - results may be better when compared to placebo.
Contact:
youngsteri@shamir.gov.il.
Abstract: Clinical Microbiology and Infection 26 (2020) 1259.e5e1259.e7
Contents lists available at ScienceDirect
Clinical Microbiology and Infection
journal homepage: www.clinicalmicrobiologyandinfection.com
Research note
Ibuprofen use and clinical outcomes in COVID-19 patients
E. Rinott 1, E. Kozer 2, 3, Y. Shapira 3, 4, A. Bar-Haim 5, I. Youngster 3, 6, *
1)
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Paediatric Emergency Unit, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel
3)
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
4)
Division of Internal Medicine, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel
5)
Molecular Laboratory, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel
6)
Paediatric Infectious Diseases, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel
2)
a r t i c l e i n f o
a b s t r a c t
Article history:
Received 12 May 2020
Received in revised form
3 June 2020
Accepted 6 June 2020
Available online 12 June 2020
Objective: It was recently suggested that ibuprofen might increase the risk for severe and fatal coronavirus disease 2019 (COVID-19) and should therefore be avoided in this patient population. We aimed to
evaluate whether ibuprofen use in individuals with COVID-19 was associated with more severe disease,
compared with individuals using paracetamol or no antipyretics.
Methods: In a retrospective cohort study of patients with COVID-19 from Shamir Medical Centre, Israel,
we monitored any use of ibuprofen from a week before diagnosis of COVID-19 throughout the disease.
Primary outcomes were mortality and the need for respiratory support, including oxygen administration
and mechanical ventilation.
Results: The study included 403 confirmed cases of COVID-19, with a median age of 45 years. Of the
entire cohort, 44 patients (11%) needed respiratory support and 12 (3%) died. One hundred and seventynine (44%) patients had fever, with 32% using paracetamol and 22% using ibuprofen, for symptom-relief.
In the ibuprofen group, 3 (3.4%) patients died, whereas in the non-ibuprofen group, 9 (2.8%) patients died
(p 0.95). Nine (10.3%) patients from the ibuprofen group needed respiratory support, compared with 35
(11%) from the non-ibuprofen group (p 1). When compared with exclusive paracetamol users, no differences were observed in mortality rates or the need for respiratory support among patients using
ibuprofen.
Conclusions: In this cohort of COVID-19 patients, ibuprofen use was not associated with worse clinical
outcomes, compared with paracetamol or no antipyretic. E. Rinott, Clin Microbiol Infect
2020;26:1259.e5e1259.e7
© 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All
rights reserved.
Editor: L. Scudeller
Keywords:
Antipyretics
Coronavirus disease 2019
Disease severity
Ibuprofen
Paracetamol
rinott
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