Clin Transl Sci. 2020 Sep 24. doi: 10.1111/cts.12904. Online ahead of print.
Recommendations regarding ibuprofen use in relation to coronavirus disease 2019 (COVID-19) have been conflicting. We examined risk of severe COVID-19 between ibuprofen-prescribed and non-ibuprofen COVID-19 patients in a nationwide register-based study of COVID-19 patients in Denmark between end of February 2020 and May 16, 2020. Patients with heart failure (n=208), <30 years (n=575), and prescribed other non-steroidal anti-inflammatory drugs (n=57) were excluded. Patients with ibuprofen prescription claims between January 1, 2020, and before COVID-19 diagnosis or April 30, 2020 (last available prescription) were compared to patients without ibuprofen prescription claims. Outcome was a 30-day composite of severe COVID-19 diagnosis with acute respiratory syndrome, intensive care unit admission, or death. Absolute risks and average risk ratios comparing outcome for ibuprofen versus non-ibuprofen patients standardized to the age, sex, and comorbidity distribution of all patients were derived from multivariable Cox regression. Among 4,002 patients, 264 (6.6%) had ibuprofen prescription claims before COVID-19. Age, sex and comorbidities were comparable between the two study groups. Standardized absolute risks of the composite outcome for ibuprofen-prescribed versus non-ibuprofen patients were 16.3% [95% CI 12.1-20.6] versus 17.0% [95% CI 16.0-18.1], P=0.74. The standardized average risk ratio for ibuprofen-prescribed versus non-ibuprofen patients was 0.96 [95% CI 0.72-1.23]. Standardized absolute risks of the composite outcome for patients with ibuprofen prescription claims >14 days before COVID-19 versus ≤14 days of COVID-19 were 17.1% [95% CI 12.3-22.0] versus 14.3% [95% CI 7.1-23.1]. In conclusion, in this nationwide study, there was no significant association between ibuprofen prescription claims and severe COVID-19.