Summary of COVID-19 indomethacin studies
Studies
Meta Analysis
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RCT with 103 indomethacin and 107 paracetamol patients, showing lower progression and improved recovery with indomethacin. Notably, improvements include faster resolution of cough. [Alkotaji] previously hypothesised the benefit of indomethacin for reducing cough via bradykinin inhibition.
Apr 2022, Scientific Reports, https://www.nature.com/articles/s41598-022-10370-1, https://c19p.org/ravichandran
PSM retrospective 72 indomethacin and 72 paracetamol patients in India, showing lower progression and improved recovery with indomethacin.
Jul 2021, J. the Indian Medical Association, https://sapiensfoundation.org/wp-content/uploads/2021/08/Use-of-Indomethacin-in-Covid-19-patients-JIMA-2021.pdf, https://c19p.org/ravichandran2
Very small RCT with 22 indomethacin and 23 control patients, showing no significant difference in outcomes. All patients were treated with HCQ.
Jan 2022, Immunopathologia Persa, https://immunopathol.com/Inpress/ipp-29284.pdf, https://c19p.org/salmasi
Analysis of interactions between viral and human proteins for SARS-CoV-2, SARS-CoV-1, and MERS-CoV and genetic screening to identify host factors that enhance or inhibit viral infection. Authors predict indomethacin will have antiviral activity for SARS-CoV-2 and perform a retrospective study of patients in the USA that started treatment within 21 days after COVID-19 infection - 103 with indomethacin, and 103 using a celecoxib, a clinically similar drug without predicted antiviral activity. There were fewer hospital visits and hospitalizations with indomethacin, without statistical significance.
Dec 2020, Science, https://www.science.org/doi/10.1126/science.abe9403, https://c19p.org/gordon3
1. Ravichandran et al., An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
210 patient indomethacin late treatment RCT: 30% improved recovery (p=0.002), 98% lower progression (p<0.0001), and 17% improved viral clearance (p=0.19).RCT with 103 indomethacin and 107 paracetamol patients, showing lower progression and improved recovery with indomethacin. Notably, improvements include faster resolution of cough. [Alkotaji] previously hypothesised the benefit of indomethacin for reducing cough via bradykinin inhibition.
Apr 2022, Scientific Reports, https://www.nature.com/articles/s41598-022-10370-1, https://c19p.org/ravichandran
2. Ravichandran et al., Use of indomethacin in COVID-19 patients: experience from two medical centres
144 patient indomethacin late treatment PSM study: 96% lower need for oxygen therapy (p<0.0001) and 43% faster recovery (p<0.0001).PSM retrospective 72 indomethacin and 72 paracetamol patients in India, showing lower progression and improved recovery with indomethacin.
Jul 2021, J. the Indian Medical Association, https://sapiensfoundation.org/wp-content/uploads/2021/08/Use-of-Indomethacin-in-Covid-19-patients-JIMA-2021.pdf, https://c19p.org/ravichandran2
3. Salmasi et al., Efficacy of oral indomethacin in the treatment of COVID-19 infection; a randomized clinical trial
45 patient indomethacin late treatment RCT: 66% lower ventilation (p=1) and 40% slower recovery (p=0.52).Very small RCT with 22 indomethacin and 23 control patients, showing no significant difference in outcomes. All patients were treated with HCQ.
Jan 2022, Immunopathologia Persa, https://immunopathol.com/Inpress/ipp-29284.pdf, https://c19p.org/salmasi
4. Gordon et al., Comparative host-coronavirus protein interaction networks reveal pan-viral disease mechanisms
206 patient indomethacin late treatment PSM study: 67% lower hospitalization (p=0.34) and 57% lower progression (p=0.21).Analysis of interactions between viral and human proteins for SARS-CoV-2, SARS-CoV-1, and MERS-CoV and genetic screening to identify host factors that enhance or inhibit viral infection. Authors predict indomethacin will have antiviral activity for SARS-CoV-2 and perform a retrospective study of patients in the USA that started treatment within 21 days after COVID-19 infection - 103 with indomethacin, and 103 using a celecoxib, a clinically similar drug without predicted antiviral activity. There were fewer hospital visits and hospitalizations with indomethacin, without statistical significance.
Dec 2020, Science, https://www.science.org/doi/10.1126/science.abe9403, https://c19p.org/gordon3
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