Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, is safe and does not lead to higher rates of death or severe disease in patients hospitalised with COVID-19, according to a new observational study of more than 72,000 people in the UK.

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NSAIDs are common treatments for acute pain and rheumatological diseases such as rheumatoid arthritis and osteoarthritis. Early in the pandemic, there was a debate on whether the use of such drugs increased the severity of COVID-19, which led to urgent calls for investigations between NSAIDs and COVID-19. But, the study, led by ISARIC CCP-UK (International Severe Acute Respiratory and Emerging Infection Consortium Clinical Characterisation Protocol United Kingdom), provides clear evidence that the continued use of NSAIDs in patients with COVID-19 is safe. The findings are published in The Lancet Rheumatology journal.

Around a third of patients (30.4 per cent) who had taken NSAIDs prior to hospital admission for COVID-19 died, a rate which was similar (31.3 per cent) in patients who had not taken NSAIDs. In patients with rheumatological disease, the use of NSAIDs did not increase mortality. Further, those who took NSAIDs were not more likely to be admitted to critical care, need invasive or non-invasive ventilation, or require oxygen, the researchers found.

"We now have clear evidence that NSAIDs are safe to use in patients with COVID-19, which should provide reassurance to both clinicians and patients that they can continue to be used in the same way as before the pandemic began", said lead author Ewen Harrison, from the University of Edinburgh. For the study, the team collected data on the medication patients had been prescribed, were currently taking, or had taken within 14 days prior to being admitted to the hospital, as well as demographic information, and medical history. Of the 72,179 patients from England, Scotland, and Wales, 5.8 per cent (4,211) had taken NSAIDs prior to hospital admission between January and August 2020.

Further research and clinical trials are needed to establish whether NSAIDs are safe in different populations and whether their anti-inflammatory effects have any impact on patients with COVID-19, the researchers said.