Perioperative Nonsteroidal Anti-Inflammatory Agents in the COVID-19 Orthopedic Patient. Review uri icon

Overview

abstract

  • BACKGROUND: SARS-CoV-2 infection can cause serious complications beyond lung injury and respiratory failure, including sepsis, cardiovascular injury, renal failure, coagulation abnormalities, and neurologic injury. Widely used medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) have been flagged as having the potential to cause harm in the context of COVID-19. It is unknown if the benefits of NSAID use in the orthopedic population will outweigh the potential risks of increased morbidity in COVID-19 orthopedic patients. METHODS: We conducted a narrative review of the use of NSAIDs in the orthopedic patient with COVID-19, focusing on the effects of NSAIDs on the inflammatory process, the role of NSAIDs in orthopedics, and the associations between NSAID use and complications of pneumonia. RESULTS: We found that it may be appropriate to consider NSAID use in otherwise healthy orthopedic patients with COVID-19 and significant pain. CONCLUSIONS: In this context, we recommend that NSAIDs be used at the lowest effective dose for the shortest duration possible in orthopedic patients with COVID-19. However, pending further data and based on the concerns outlined in this review, we recommend avoiding NSAIDs in orthopedic patients with significant comorbidities and those who are undergoing major orthopedic surgery.

publication date

  • September 14, 2020

Identity

PubMed Central ID

  • PMC7489195

Scopus Document Identifier

  • 85081901579

Digital Object Identifier (DOI)

  • 10.1016/S0140-6736(20)30566-3

PubMed ID

  • 32952464

Additional Document Info

volume

  • 16

issue

  • Suppl 1