COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting?

Russell, Beth; Moss, Charlotte; Rigg, Anne; Van Hemelrijck, Mieke

In conclusion, the existing literature does not currently provide conclusive evidence for or against the use of NSAIDs in the treatment of COVID-19 patients, though there appears to be some evidence that corticosteroids may be beneficial if utilised in the early acute phase of infection [14] . However, it is important to note this is not specific to COVID-19. Indeed, one review stated that the WHO does not currently recommend corticosteroids in other viral diseases, like Dengue as the 'glucocorticoid-mediated stimulation of the hypothalamicpituitaryadrenal axis can also drive lymphocytopenia, or it may promote exaggerated pro-inflammatory responses that eventually cause a worsening of the pathogenic condition'. These are unprecedented times for the medical community and although evidence suggests a potential role for the use of NSAIDs and corticosteroids in COVID-19 treatment, caution should be exercised until further evidence, specific to this infection strain, emerges. The same guidance stands for cancer patients who are not advised to change their medication routine unless told otherwise by their doctor.