No.or, anti-inflammatories are not the solution to the Covid-19 problem. Thinking that through them most of the hospitalizations and deaths in these pandemic years could have been avoided is not at all reflected. Inserted as early as 2020 in the guidelines on the treatment of Covid-19 by the Ministry of Health, the anti-inflammatory they can be useful in improving symptoms such as muscle and joint pain associated with infection but, by not acting directly against the virus, they do not represent a specific cure for Covid-19. That is why the narrative that early use of NSAIDs would reduce hospitalizations by 90% is misleading and out of context.
What is used for Covid-19?
The symptomatic therapy of Covid-19, still today, first of all involves the use of paracetamol or NSAIDs (non-steroidal anti-inflammatory drugs) in case of fever, joint and muscle pain except in cases where their use is not recommended (these molecules DO NOT act against the virus but mitigate the symptoms). If the patient is no longer able to saturate satisfactorily and therefore needs supplemental oxygen, it is possible to administer corticosteroids. The use of the latter, however, is not indicated in the initial phase of the disease as they could even be harmful. This is because in the active stage of virus replication inflammation plays an important role in eradicating the virus. When even with corticosteroids the situation worsens, then hospitalization and treatment with any other drugs – based on the patient’s overall clinical picture – is necessary, such as, for example, monoclonal antibodies (both directed against the virus and directed against inflammatory molecules such as IL-6) and anticoagulants.
Few supporting data
Recently a review published on Lancet Infectious Diseases by researchers from the Mario Negri Institute of Pharmacological Research in Milan, he tried to analyze several studies that had as their object the use of anti-inflammatories at home. The analysis, which states that the use of these molecules can help in the early stages of the disease, however, has been interpreted on a communicative level with the misleading message that the early use of NSAIDs would reduce hospitalizations by 90%. But in the review, this data refers to a single study that evaluated the reduction in the total number of hospitalization days and the reduction in costs. Study carried out on a very small sample (90 people) and not very representative that cannot at all allow to draw such a strong conclusion.
Covid, the role of antivirals
The situation is different with regard to antivirals. These, unlike the anti-inflammatories that act on the symptoms, directly interfere with the replication of the virus. At present there are two approved for Covid-19: Nirmatrelvir + ritonavir (Paxlovid) and molnupiravir (Lagevrio). Both of these drugs are available for free in our country. A recent study published in August by the New England Journal of Medicine on a sample of over 100,000 people, it has shown that early use of Paxlovid reduces the risk of hospitalization and death by 80% in individuals over the age of 65. To think that before their arrival in February 2022 they could have saved lives simply by prescribing NSAIDs does not find any scientific confirmation.
To know more
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