COVID-19 and non-steroid anti-inflammatory drugs

Abstract

The literature review deals with the analysis of the results of studies on the effectiveness and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) in the intensive care programs for patients with COVID-19 in 2020–2021. NSAIDs used for other indications or low-dose aspirin do not increase the body’s sensitivity to SARS-CoV-2 and are not additional risk factors for the severity of the course and mortality from COVID-19. Therefore, in patients receiving NSAIDs or low-dose aspirin for comorbid conditions, these drugs should not be withdrawn and may be used during the treatment of COVID-19. It has now been clarified that the pro-inflammatory effect in SARS-CoV-2 is caused by prostaglandins. Suppression of their production with the help of NSAIDs can have a positive effect during the initial phase of a viral infection, before the development of acute respiratory distress syndrome. To date, the clinical benefits of low-dose aspirin for the primary prevention of thrombotic complications in hospitalized patients with COVID-19 have not been proven, and therefore it is not recommended to use aspirin for this purpose.