Adverse Outcomes and Mortality in Users of Non-Steroidal Anti-Inflammatory Drugs tested positive for SARS-CoV-2: A Danish Nationwide Cohort Study
Adverse Outcomes and Mortality in Users of Non-Steroidal Anti-Inflammatory Drugs tested positive for SARS-CoV-2: A Danish Nationwide Cohort Study
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SARS-CoV-2 检测呈阳性的非类固醇抗炎药使用者的不良后果和死亡率：丹麦全国队列研究
DOI：
10.1101/2020.06.08.20115683
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Anton Pottegaard
中科院分区：
文献类型：
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作者：
L. Lund;K. Kristensen;Mette Reilev;S. Christensen;R. Thomsen;C. Christiansen;Henrik Stoevring;N. B. Johansen;N. Brun;J. Hallas;Anton Pottegaard
背景在SARS-CoV-2感染期间使用非类固醇抗炎药(NSAID)的安全性已引起关注。目的研究非甾体抗炎药(NSAIDs)的使用是否与SARS-CoV-2感染期间的不良结局和死亡率有关。设计以人群为基础的队列研究，设置丹麦的行政和健康登记。参与者在2020年2月27日至2020年4月29日期间检测出SARS-CoV-2呈阳性。接受治疗的患者(被定义为在SARS-CoV-2测试前30天内填写非甾体抗炎药处方)与最多4名未接受治疗的患者在基于年龄、性别、相关合并症和处方填写的倾向评分上进行匹配。结果指标：主要结果是30天的死亡率，并使用风险比(RR)和风险差异(RD)对接受治疗和未接受治疗的患者进行比较。次要结果包括住院、重症监护病房(ICU)入院、机械通气和急性肾脏替代治疗。结果共有9236例SARS-CoV-2阳性个体符合纳入标准。其中248人(2.7%)开了非类固醇抗炎药的处方，5.8%的人在30天内死亡。在配对分析中，非甾体抗炎药治疗与30天死亡率(RR 1.02，95%CI 0.57至1.82；RD 0.1%，-3.5%至3.7%)、住院风险增加(RR 1.16，0.87至1.53；RD 3.3%，-3.4%至10%)、ICU入院(RR 1.04，0.54至2.02；RD0.2%，-3.0%~3.4%)、机械通气(RR1.14，0.56~2.30；RD0.5%，-2.5%~3.6%)或肾脏替代治疗(RR0.86，0.24~3.09；RD0.2%，-2.0%~1.6%)。结论在SARS-CoV-2检测呈阳性的丹麦人中，非类固醇抗炎药的使用与30天死亡率、住院、ICU入院、机械呼吸或肾脏替代治疗无关。注册：欧盟授权后研究电子登记册，EUPAS-34734(http://www.encepp.eu/encepp/viewResource.htm?id=34735)
Background Concerns over the safety of non-steroidal anti-inflammatory drug (NSAID) use during SARS-CoV-2 infection have been raised. Objectives To study whether use of NSAIDs is associated with adverse outcomes and mortality during SARS-CoV-2 infection. Design Population based cohort study Setting Danish administrative and health registries. Participants Individuals tested positive for SARS-CoV-2 during Feb 27, 2020 to Apr 29, 2020. Treated individuals (defined as a filled NSAID prescription up to 30 days before the SARS-CoV-2 test) were matched to up to 4 non-treated individuals on propensity scores based on age, sex, relevant comorbidities and prescription fills. Outcome measures The main outcome was 30-day mortality and treated individuals were compared to untreated individuals using risk ratios (RR) and risk differences (RD). Secondary outcomes included hospitalisation, intensive care unit (ICU) admission, mechanical ventilation and acute renal replacement therapy. Results A total of 9236 SARS-CoV-2 PCR positive individuals were eligible for inclusion. Of these, 248 (2.7%) had filled a prescription for NSAIDs and 535 (5.8%) died within 30 days. In the matched analyses, treatment with NSAIDs was not associated with 30-day mortality (RR 1.02, 95% CI 0.57 to 1.82; RD 0.1%, -3.5% to 3.7%), increased risk of hospitalisation (RR 1.16, 0.87 to 1.53; RD 3.3%, -3.4% to 10%), ICU-admission (RR 1.04, 0.54 to 2.02; RD 0.2%, -3.0% to 3.4%), mechanical ventilation (RR 1.14, 0.56 to 2.30; RD 0.5%, -2.5% to 3.6%), or renal replacement therapy (RR 0.86, 0.24 to 3.09; RD -0.2%, -2.0% to 1.6%). Conclusion Use of NSAIDs was not associated with 30-day mortality, hospitalisation, ICU-admission, mechanical ventilation or renal replacement therapy in Danish individuals tested positive for SARS-CoV-2. Registration: The European Union electronic Register of Post-Authorisation Studies, EUPAS-34734 (http://www.encepp.eu/encepp/viewResource.htm?id=34735)