Association of Nonsteroidal Anti-inflammatory Drug Use and Adverse Outcomes Among Patients Hospitalized With Influenza.
Identifieur interne : 000788 ( Main/Exploration ); précédent : 000787; suivant : 000789Association of Nonsteroidal Anti-inflammatory Drug Use and Adverse Outcomes Among Patients Hospitalized With Influenza.
Auteurs : Lars Christian Lund [Danemark] ; Mette Reilev [Danemark] ; Jesper Hallas [Danemark] ; Kasper Bruun Kristensen [Danemark] ; Reimar Wernich Thomsen [Danemark] ; Christian Fynbo Christiansen [Danemark] ; Henrik Toft S Rensen [Danemark, États-Unis] ; Nanna Borup Johansen [Danemark] ; Nikolai Constantin Brun [Danemark] ; Marianne Voldstedlund [Danemark] ; Henrik St Vring [Danemark] ; Marianne Kragh Thomsen [Danemark] ; Steffen Christensen [Danemark] ; Anton Potteg Rd [Danemark]Source :
- JAMA network open [ 2574-3805 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Anti-inflammatoires non stéroïdiens (effets indésirables), Anti-inflammatoires non stéroïdiens (pharmacologie), Betacoronavirus (MeSH), Danemark (épidémiologie), Femelle (MeSH), Grippe humaine (MeSH), Hospitalisation (MeSH), Humains (MeSH), Infections à coronavirus (complications), Infections à coronavirus (mortalité), Infections à coronavirus (traitement médicamenteux), Infections à coronavirus (virologie), Mâle (MeSH), Odds ratio (MeSH), Pandémies (MeSH), Pneumopathie infectieuse (MeSH), Pneumopathie virale (complications), Pneumopathie virale (mortalité), Pneumopathie virale (traitement médicamenteux), Pneumopathie virale (virologie), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Unités de soins intensifs (MeSH), Études de cohortes (MeSH).
- MESH :
- effets indésirables : Anti-inflammatoires non stéroïdiens, Infections à coronavirus, Pneumopathie virale.
- mortalité : Infections à coronavirus, Pneumopathie virale.
- pharmacologie : Anti-inflammatoires non stéroïdiens.
- traitement médicamenteux : Infections à coronavirus, Pneumopathie virale.
- virologie : Infections à coronavirus, Pneumopathie virale.
- épidémiologie : Danemark.
- Adulte, Adulte d'âge moyen, Betacoronavirus, Femelle, Grippe humaine, Hospitalisation, Humains, Mâle, Odds ratio, Pandémies, Pneumopathie infectieuse, Sujet âgé, Sujet âgé de 80 ans ou plus, Unités de soins intensifs, Études de cohortes.
- Wicri :
- geographic : Danemark.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Anti-Inflammatory Agents, Non-Steroidal (adverse effects), Anti-Inflammatory Agents, Non-Steroidal (pharmacology), Betacoronavirus (MeSH), COVID-19 (MeSH), Cohort Studies (MeSH), Coronavirus Infections (complications), Coronavirus Infections (drug therapy), Coronavirus Infections (mortality), Coronavirus Infections (virology), Denmark (epidemiology), Female (MeSH), Hospitalization (MeSH), Humans (MeSH), Influenza, Human (MeSH), Intensive Care Units (MeSH), Male (MeSH), Middle Aged (MeSH), Odds Ratio (MeSH), Pandemics (MeSH), Pneumonia (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (drug therapy), Pneumonia, Viral (mortality), Pneumonia, Viral (virology), SARS-CoV-2 (MeSH).
- MESH :
- chemical , adverse effects : Anti-Inflammatory Agents, Non-Steroidal.
- chemical , pharmacology : Anti-Inflammatory Agents, Non-Steroidal.
- geographic , epidemiology : Denmark.
- complications : Coronavirus Infections, Pneumonia, Viral.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- virology : Coronavirus Infections, Pneumonia, Viral.
- Adult, Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Cohort Studies, Female, Hospitalization, Humans, Influenza, Human, Intensive Care Units, Male, Middle Aged, Odds Ratio, Pandemics, Pneumonia, SARS-CoV-2.
Abstract
Importance
During the ongoing coronavirus disease 2019 pandemic, case reports have suggested that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may lead to adverse outcomes.
Objective
To study the association of NSAID use with adverse outcomes in patients hospitalized with influenza or influenza pneumonia.
Design, Setting, and Participants
This cohort study used propensity score matching among 7747 individuals aged 40 years or older who were hospitalized with influenza, confirmed by polymerase chain reaction or antigen testing, between 2010 and 2018. Data were collected using Danish nationwide registers. All analyses reported were performed on May 29, 2020.
Exposures
Prescription fill of an NSAID within 60 days before admission.
Main Outcomes and Measures
Risk ratio (RR) and risk difference (RD) with 95% CIs for intensive care unit admission and death within 30 days of admission.
Results
A total of 7747 patients (median [interquartile range] age, 71 [59-80] years, 3980 [51.4%] men) with confirmed influenza were identified. Of these, 520 (6.7%) were exposed to NSAIDs. In the unmatched cohorts, 104 of 520 patients (20.0%) who used NSAIDs and 958 of 7227 patients (13.3%) who did not use NSAIDs were admitted to the intensive care unit. For death within 30 days of admission, we observed 37 events (7.1%) among those who used NSAIDs compared with 563 events (7.8%) among those who did not. Current NSAID use was associated with intensive care unit admission (RR, 1.51; 95% CI, 1.26 to 1.81; RD, 6.7%; 95% CI, 3.2% to 10.3%), while NSAID use was not associated with death (RR, 0.91; 95% CI, 0.66 to 1.26; RD, -0.7%; 95% CI, -3.0% to 1.6%). In the matched cohorts, risks were unchanged for patients who used NSAIDs, while 83 ICU admissions (16.0%) and 36 deaths (6.9%) were observed among matched individuals who did not use NSAIDs. Matched (ie, adjusted) analyses yielded attenuated risk estimates for intensive care unit admission (RR, 1.25; 95% CI, 0.95 to 1.63; RD, 4.0%; 95% CI, -0.6% to 8.7%) and death (RR, 1.03; 95% CI, 0.66 to 1.60; RD, 0.2%; 95% CI, -2.9% to 3.3%). Associations were more pronounced among patients who used NSAIDs for a longer period (eg, for intensive care unit admission: RR, 1.90; 95% CI, 1.19 to 3.06; RD, 13.4%; 95% CI, 4.0% to 22.8%).
Conclusions and Relevance
In this cohort study of adult patients hospitalized with influenza, the use of NSAIDs was not associated with 30-day intensive care unit admission or death in adjusted analyses. There was an association between long-term use of NSAIDs and intensive care unit admission.
DOI: 10.1001/jamanetworkopen.2020.13880
PubMed: 32609352
PubMed Central: PMC7330719
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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sort="Reilev, Mette" uniqKey="Reilev M" first="Mette" last="Reilev">Mette Reilev</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author><author><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Biochemistry and Clinical Pharmacology, Odense University Hospital, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Biochemistry and Clinical Pharmacology, Odense University Hospital, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author><author><name sortKey="Kristensen, Kasper Bruun" sort="Kristensen, Kasper Bruun" uniqKey="Kristensen K" first="Kasper Bruun" last="Kristensen">Kasper Bruun Kristensen</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author><author><name sortKey="Thomsen, Reimar Wernich" sort="Thomsen, Reimar Wernich" uniqKey="Thomsen R" first="Reimar Wernich" last="Thomsen">Reimar Wernich Thomsen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Christiansen, Christian Fynbo" sort="Christiansen, Christian Fynbo" uniqKey="Christiansen C" first="Christian Fynbo" last="Christiansen">Christian Fynbo Christiansen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="S Rensen, Henrik Toft" sort="S Rensen, Henrik Toft" uniqKey="S Rensen H" first="Henrik Toft" last="S Rensen">Henrik Toft S Rensen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Center for Population Health and Sciences, Stanford University, Stanford, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Center for Population Health and Sciences, Stanford University, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Johansen, Nanna Borup" sort="Johansen, Nanna Borup" uniqKey="Johansen N" first="Nanna Borup" last="Johansen">Nanna Borup Johansen</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Brun, Nikolai Constantin" sort="Brun, Nikolai Constantin" uniqKey="Brun N" first="Nikolai Constantin" last="Brun">Nikolai Constantin Brun</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Voldstedlund, Marianne" sort="Voldstedlund, Marianne" uniqKey="Voldstedlund M" first="Marianne" last="Voldstedlund">Marianne Voldstedlund</name><affiliation wicri:level="3"><nlm:affiliation>Statens Serum Institut, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Statens Serum Institut, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="St Vring, Henrik" sort="St Vring, Henrik" uniqKey="St Vring H" first="Henrik" last="St Vring">Henrik St Vring</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Public Health-Biostatistics, Aarhus University, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Public Health-Biostatistics, Aarhus University, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Thomsen, Marianne Kragh" sort="Thomsen, Marianne Kragh" uniqKey="Thomsen M" first="Marianne Kragh" last="Thomsen">Marianne Kragh Thomsen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Christensen, Steffen" sort="Christensen, Steffen" uniqKey="Christensen S" first="Steffen" last="Christensen">Steffen Christensen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Potteg Rd, Anton" sort="Potteg Rd, Anton" uniqKey="Potteg Rd A" first="Anton" last="Potteg Rd">Anton Potteg Rd</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Hospital Pharmacy Funen, Odense University Hospital, Odense</wicri:regionArea><wicri:noRegion>Odense</wicri:noRegion></affiliation></author></analytic><series><title level="j">JAMA network open</title><idno type="eISSN">2574-3805</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Anti-Inflammatory Agents, Non-Steroidal (adverse effects)</term><term>Anti-Inflammatory Agents, Non-Steroidal (pharmacology)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Cohort Studies (MeSH)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (drug therapy)</term><term>Coronavirus Infections (mortality)</term><term>Coronavirus Infections (virology)</term><term>Denmark (epidemiology)</term><term>Female (MeSH)</term><term>Hospitalization (MeSH)</term><term>Humans (MeSH)</term><term>Influenza, Human (MeSH)</term><term>Intensive Care Units (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Odds Ratio (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (drug therapy)</term><term>Pneumonia, Viral (mortality)</term><term>Pneumonia, Viral (virology)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Anti-inflammatoires non stéroïdiens (effets indésirables)</term><term>Anti-inflammatoires non stéroïdiens (pharmacologie)</term><term>Betacoronavirus (MeSH)</term><term>Danemark (épidémiologie)</term><term>Femelle (MeSH)</term><term>Grippe humaine (MeSH)</term><term>Hospitalisation (MeSH)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (mortalité)</term><term>Infections à coronavirus (traitement médicamenteux)</term><term>Infections à coronavirus (virologie)</term><term>Mâle (MeSH)</term><term>Odds ratio (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie infectieuse (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (mortalité)</term><term>Pneumopathie virale (traitement médicamenteux)</term><term>Pneumopathie virale (virologie)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Unités de soins intensifs (MeSH)</term><term>Études de cohortes (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Anti-Inflammatory Agents, Non-Steroidal</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Anti-Inflammatory Agents, Non-Steroidal</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Denmark</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Anti-inflammatoires non stéroïdiens</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="pharmacologie" xml:lang="fr"><term>Anti-inflammatoires non stéroïdiens</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Danemark</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Betacoronavirus</term><term>COVID-19</term><term>Cohort Studies</term><term>Female</term><term>Hospitalization</term><term>Humans</term><term>Influenza, Human</term><term>Intensive Care Units</term><term>Male</term><term>Middle Aged</term><term>Odds Ratio</term><term>Pandemics</term><term>Pneumonia</term><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Betacoronavirus</term><term>Femelle</term><term>Grippe humaine</term><term>Hospitalisation</term><term>Humains</term><term>Mâle</term><term>Odds ratio</term><term>Pandémies</term><term>Pneumopathie infectieuse</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Unités de soins intensifs</term><term>Études de cohortes</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Danemark</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Importance</b></p><p>During the ongoing coronavirus disease 2019 pandemic, case reports have suggested that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may lead to adverse outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>Objective</b></p><p>To study the association of NSAID use with adverse outcomes in patients hospitalized with influenza or influenza pneumonia.</p></div><div type="abstract" xml:lang="en"><p><b>Design, Setting, and Participants</b></p><p>This cohort study used propensity score matching among 7747 individuals aged 40 years or older who were hospitalized with influenza, confirmed by polymerase chain reaction or antigen testing, between 2010 and 2018. Data were collected using Danish nationwide registers. All analyses reported were performed on May 29, 2020.</p></div><div type="abstract" xml:lang="en"><p><b>Exposures</b></p><p>Prescription fill of an NSAID within 60 days before admission.</p></div><div type="abstract" xml:lang="en"><p><b>Main Outcomes and Measures</b></p><p>Risk ratio (RR) and risk difference (RD) with 95% CIs for intensive care unit admission and death within 30 days of admission.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>A total of 7747 patients (median [interquartile range] age, 71 [59-80] years, 3980 [51.4%] men) with confirmed influenza were identified. Of these, 520 (6.7%) were exposed to NSAIDs. In the unmatched cohorts, 104 of 520 patients (20.0%) who used NSAIDs and 958 of 7227 patients (13.3%) who did not use NSAIDs were admitted to the intensive care unit. For death within 30 days of admission, we observed 37 events (7.1%) among those who used NSAIDs compared with 563 events (7.8%) among those who did not. Current NSAID use was associated with intensive care unit admission (RR, 1.51; 95% CI, 1.26 to 1.81; RD, 6.7%; 95% CI, 3.2% to 10.3%), while NSAID use was not associated with death (RR, 0.91; 95% CI, 0.66 to 1.26; RD, -0.7%; 95% CI, -3.0% to 1.6%). In the matched cohorts, risks were unchanged for patients who used NSAIDs, while 83 ICU admissions (16.0%) and 36 deaths (6.9%) were observed among matched individuals who did not use NSAIDs. Matched (ie, adjusted) analyses yielded attenuated risk estimates for intensive care unit admission (RR, 1.25; 95% CI, 0.95 to 1.63; RD, 4.0%; 95% CI, -0.6% to 8.7%) and death (RR, 1.03; 95% CI, 0.66 to 1.60; RD, 0.2%; 95% CI, -2.9% to 3.3%). Associations were more pronounced among patients who used NSAIDs for a longer period (eg, for intensive care unit admission: RR, 1.90; 95% CI, 1.19 to 3.06; RD, 13.4%; 95% CI, 4.0% to 22.8%).</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions and Relevance</b></p><p>In this cohort study of adult patients hospitalized with influenza, the use of NSAIDs was not associated with 30-day intensive care unit admission or death in adjusted analyses. There was an association between long-term use of NSAIDs and intensive care unit admission.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32609352</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>09</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>18</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">2574-3805</ISSN><JournalIssue CitedMedium="Internet"><Volume>3</Volume><Issue>7</Issue><PubDate><Year>2020</Year><Month>07</Month><Day>01</Day></PubDate></JournalIssue><Title>JAMA network open</Title><ISOAbbreviation>JAMA Netw Open</ISOAbbreviation></Journal><ArticleTitle>Association of Nonsteroidal Anti-inflammatory Drug Use and Adverse Outcomes Among Patients Hospitalized With Influenza.</ArticleTitle><Pagination><MedlinePgn>e2013880</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1001/jamanetworkopen.2020.13880</ELocationID><Abstract><AbstractText Label="Importance">During the ongoing coronavirus disease 2019 pandemic, case reports have suggested that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may lead to adverse outcomes.</AbstractText><AbstractText Label="Objective">To study the association of NSAID use with adverse outcomes in patients hospitalized with influenza or influenza pneumonia.</AbstractText><AbstractText Label="Design, Setting, and Participants">This cohort study used propensity score matching among 7747 individuals aged 40 years or older who were hospitalized with influenza, confirmed by polymerase chain reaction or antigen testing, between 2010 and 2018. Data were collected using Danish nationwide registers. All analyses reported were performed on May 29, 2020.</AbstractText><AbstractText Label="Exposures">Prescription fill of an NSAID within 60 days before admission.</AbstractText><AbstractText Label="Main Outcomes and Measures">Risk ratio (RR) and risk difference (RD) with 95% CIs for intensive care unit admission and death within 30 days of admission.</AbstractText><AbstractText Label="Results">A total of 7747 patients (median [interquartile range] age, 71 [59-80] years, 3980 [51.4%] men) with confirmed influenza were identified. Of these, 520 (6.7%) were exposed to NSAIDs. In the unmatched cohorts, 104 of 520 patients (20.0%) who used NSAIDs and 958 of 7227 patients (13.3%) who did not use NSAIDs were admitted to the intensive care unit. For death within 30 days of admission, we observed 37 events (7.1%) among those who used NSAIDs compared with 563 events (7.8%) among those who did not. Current NSAID use was associated with intensive care unit admission (RR, 1.51; 95% CI, 1.26 to 1.81; RD, 6.7%; 95% CI, 3.2% to 10.3%), while NSAID use was not associated with death (RR, 0.91; 95% CI, 0.66 to 1.26; RD, -0.7%; 95% CI, -3.0% to 1.6%). In the matched cohorts, risks were unchanged for patients who used NSAIDs, while 83 ICU admissions (16.0%) and 36 deaths (6.9%) were observed among matched individuals who did not use NSAIDs. Matched (ie, adjusted) analyses yielded attenuated risk estimates for intensive care unit admission (RR, 1.25; 95% CI, 0.95 to 1.63; RD, 4.0%; 95% CI, -0.6% to 8.7%) and death (RR, 1.03; 95% CI, 0.66 to 1.60; RD, 0.2%; 95% CI, -2.9% to 3.3%). Associations were more pronounced among patients who used NSAIDs for a longer period (eg, for intensive care unit admission: RR, 1.90; 95% CI, 1.19 to 3.06; RD, 13.4%; 95% CI, 4.0% to 22.8%).</AbstractText><AbstractText Label="Conclusions and Relevance">In this cohort study of adult patients hospitalized with influenza, the use of NSAIDs was not associated with 30-day intensive care unit admission or death in adjusted analyses. There was an association between long-term use of NSAIDs and intensive care unit admission.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lund</LastName><ForeName>Lars Christian</ForeName><Initials>LC</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Reilev</LastName><ForeName>Mette</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hallas</LastName><ForeName>Jesper</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Clinical Biochemistry and Clinical Pharmacology, Odense University Hospital, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kristensen</LastName><ForeName>Kasper Bruun</ForeName><Initials>KB</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomsen</LastName><ForeName>Reimar Wernich</ForeName><Initials>RW</Initials><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Christiansen</LastName><ForeName>Christian Fynbo</ForeName><Initials>CF</Initials><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sørensen</LastName><ForeName>Henrik Toft</ForeName><Initials>HT</Initials><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Population Health and Sciences, Stanford University, Stanford, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Johansen</LastName><ForeName>Nanna Borup</ForeName><Initials>NB</Initials><AffiliationInfo><Affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brun</LastName><ForeName>Nikolai Constantin</ForeName><Initials>NC</Initials><AffiliationInfo><Affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Voldstedlund</LastName><ForeName>Marianne</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Statens Serum Institut, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Støvring</LastName><ForeName>Henrik</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Public Health-Biostatistics, Aarhus University, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomsen</LastName><ForeName>Marianne Kragh</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Christensen</LastName><ForeName>Steffen</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pottegård</LastName><ForeName>Anton</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>07</Month><Day>01</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>JAMA Netw Open</MedlineTA><NlmUniqueID>101729235</NlmUniqueID><ISSNLinking>2574-3805</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000894">Anti-Inflammatory Agents, Non-Steroidal</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000894" MajorTopicYN="N">Anti-Inflammatory Agents, Non-Steroidal</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003718" MajorTopicYN="N" Type="Geographic">Denmark</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="Y">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007362" MajorTopicYN="Y">Intensive Care Units</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011014" MajorTopicYN="N">Pneumonia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" 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sortKey="Lund, Lars Christian" sort="Lund, Lars Christian" uniqKey="Lund L" first="Lars Christian" last="Lund">Lars Christian Lund</name></noRegion><name sortKey="Brun, Nikolai Constantin" sort="Brun, Nikolai Constantin" uniqKey="Brun N" first="Nikolai Constantin" last="Brun">Nikolai Constantin Brun</name><name sortKey="Christensen, Steffen" sort="Christensen, Steffen" uniqKey="Christensen S" first="Steffen" last="Christensen">Steffen Christensen</name><name sortKey="Christiansen, Christian Fynbo" sort="Christiansen, Christian Fynbo" uniqKey="Christiansen C" first="Christian Fynbo" last="Christiansen">Christian Fynbo Christiansen</name><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name><name sortKey="Johansen, Nanna Borup" sort="Johansen, Nanna Borup" uniqKey="Johansen N" first="Nanna Borup" last="Johansen">Nanna Borup Johansen</name><name sortKey="Kristensen, Kasper Bruun" sort="Kristensen, Kasper Bruun" uniqKey="Kristensen K" first="Kasper Bruun" last="Kristensen">Kasper Bruun Kristensen</name><name sortKey="Potteg Rd, Anton" sort="Potteg Rd, Anton" uniqKey="Potteg Rd A" first="Anton" last="Potteg Rd">Anton Potteg Rd</name><name sortKey="Potteg Rd, Anton" sort="Potteg Rd, Anton" uniqKey="Potteg Rd A" first="Anton" last="Potteg Rd">Anton Potteg Rd</name><name sortKey="Reilev, Mette" sort="Reilev, Mette" uniqKey="Reilev M" first="Mette" last="Reilev">Mette Reilev</name><name sortKey="S Rensen, Henrik Toft" sort="S Rensen, Henrik Toft" uniqKey="S Rensen H" first="Henrik Toft" last="S Rensen">Henrik Toft S Rensen</name><name sortKey="St Vring, Henrik" sort="St Vring, Henrik" uniqKey="St Vring H" first="Henrik" last="St Vring">Henrik St Vring</name><name sortKey="St Vring, Henrik" sort="St Vring, Henrik" uniqKey="St Vring H" first="Henrik" last="St Vring">Henrik St Vring</name><name sortKey="Thomsen, Marianne Kragh" sort="Thomsen, Marianne Kragh" uniqKey="Thomsen M" first="Marianne Kragh" last="Thomsen">Marianne Kragh Thomsen</name><name sortKey="Thomsen, Reimar Wernich" sort="Thomsen, Reimar Wernich" uniqKey="Thomsen R" first="Reimar Wernich" last="Thomsen">Reimar Wernich Thomsen</name><name sortKey="Voldstedlund, Marianne" sort="Voldstedlund, Marianne" uniqKey="Voldstedlund M" first="Marianne" last="Voldstedlund">Marianne Voldstedlund</name></country><country name="États-Unis"><region name="Californie"><name sortKey="S Rensen, Henrik Toft" sort="S Rensen, Henrik Toft" uniqKey="S Rensen H" first="Henrik Toft" last="S Rensen">Henrik Toft S Rensen</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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