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Use of NSAIDs in patients with COVID-19: what is the evidence?

Key Points:

  • There is insufficient evidence that NSAIDs negatively impact morbidity or mortality of COVID-19.
  • Health Canada continues to recommend both ibuprofen and acetaminophen for treatment of fever due to COVID-19.1
  • Evidence to date suggests that older people (>60 years of age) and those with underlying medical conditions are at higher risk of severe COVID-19 disease. As NSAIDs should also be used with caution in these populations, it is reasonable to avoid NSAIDs in the elderly and in those with comorbid conditions (e.g., cardiovascular disease, renal disease, chronic respiratory disease). If the use of an NSAID is unavoidable in these patients, it should be at the lowest effective dose and for the shortest duration.
  • The CPhA monograph Nonsteroidal Anti-inflammatory Drugs (NSAIDs) contains detailed information on the contraindications, warning and precautions to consider when recommending or prescribing NSAIDs.2
  • The potential impact of corticosteroids on COVID-19 is not within the scope of this statement.
  • The COVID-19 situation is evolving and data collection is ongoing. The NSAID evidence will be reviewed as it becomes available and this statement will be updated accordingly.

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