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0 0.5 1 1.5 2+ Mortality -473% Improvement Relative Risk Oxygen therapy -534% Rinott et al. Acetaminophen for COVID-19 EARLY Is early treatment with acetaminophen beneficial for COVID-19? Retrospective 134 patients in Israel (March - April 2020) Study compares with ibuprofen, results vs. placebo may differ Higher mortality (p=0.3) and higher need for oxygen therapy (p=0.055), not stat. sig. Rinott et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.06.003 Favors acetaminophen Favors ibuprofen
Ibuprofen use and clinical outcomes in COVID-19 patients
Rinott et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.06.003
Rinott et al., Ibuprofen use and clinical outcomes in COVID-19 patients, Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.06.003
Sep 2020   Source   PDF  
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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).
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%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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.
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Abstract: Clinical Microbiology and Infection 26 (2020) 1259.e5e1259.e7 Contents lists available at ScienceDirect Clinical Microbiology and Infection journal homepage: 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
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