COVID-19 and NSAIDS: A Narrative Review of Knowns and Unknowns
Autor: | Jo Ann LeQuang, Joseph V. Pergolizzi, Paul J. Christo, Antonella Paladini, Charles Wollmuth, Peter Magnusson, Giustino Varrassi, Frank Breve, Robert W. Taylor |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Acetaminophen
COVID-19 Ibuprofen NSAIDs Paracetamol SARS-nCoV-2 virus medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Exacerbation Clinical Neurology Disease Pharmacology and Toxicology digestive system Anesthesiology medicine RD78.3-87.3 Dosing Intensive care medicine skin and connective tissue diseases business.industry medicine.disease Farmakologi och toxikologi digestive system diseases Anesthesiology and Pain Medicine Commentary Narrative review Neurology (clinical) Cytokine storm business medicine.drug |
Zdroj: | Pain and Therapy, Vol 9, Iss 2, Pp 353-358 (2020) Pain and Therapy |
ISSN: | 2193-8237 |
Popis: | Concern about the appropriate role of nonsteroidal anti-inflammatory drugs (NSAIDs) in COVID-19 speculate that NSAIDs, in particular ibuprofen, may upregulate the entry point for the virus, the angiotensin-converting enzyme (ACE) 2 receptors and increase susceptibility to the virus or worsen symptoms in existing disease. Adverse outcomes with COVID-19 have been linked to cytokine storm but the most effective way to address exaggerated inflammatory response is complex and unclear. The Expert Working Group on the Commission of Human Medicines in the UK and other organizations have stated that there is insufficient evidence to establish a link between ibuprofen and susceptibility to or exacerbation of COVID-19. NSAID use must also be categorized by whether the drugs are relatively low-dose over-the-counter oral products taken occasionally versus higher-dose or parenteral NSAIDs. Even if evidence emerged arguing for or against NSAIDs in this setting, it is unclear if this evidence would apply to all NSAIDs at all doses in all dosing regimens. Paracetamol (acetaminophen) has been proposed as an alternative to NSAIDs but there are issues with liver toxicity at high doses. There are clearly COVID-19 cases where NSAIDs should not be used, but there is no strong evidence that NSAIDs must be avoided in all patients with COVID-19; clinicians must weigh these choices on an individual basis. |
Databáze: | OpenAIRE |
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