Anti-inflammatories and Covid: Treatment with NSAIDs (non-steroidal drugs) at the onset of symptoms significantly lowers hospitalisation risk

Lancet study on anti-inflammatories and covid, analysis by Italian virologist Dr Pregliasco

‘This study confirms what was already known over time.

That is, the terrible situation of interstitial pneumonia is in fact an excessive inflammatory response that is not properly governed by the organism, which in a clumsy attempt triggers a very high level of inflammation at the level of the pulmonary alveoli, which, however, increases, thickens, the walls of the alveoli and reduces the capacity for gas exchange’.

This is how the virologist of the State University of Milan, Fabrizio Pregliasco, comments on the data of a research published in ‘Lancet Infectious Diseases’, conducted by the Mario Negri Institute for Pharmacological Research and the Asst Papa Giovanni XXIII of Bergamo, which shows that therapy with anti-inflammatory drugs, particularly non-steroidal drugs, NSAIDs, started at the onset of Covid-19 symptoms, reduces the risk of hospitalisation by 85-90%.

ANTI-INFLAMMATORIES, THE CYTOKINETIC STORM

‘Just as we had already pointed out,’ Pregliasco continues, ‘the difference is between a benign course, or at least one with a more or less rapid and challenging resolution, and that five-day cytochemical storm.

That is, whoever triggers this cytokine storm exaggerates the immune response, and this is done, not by chance, mainly by the elderly as opposed to the young, who govern this response better, regulating it to the right degree.

And this is where it is confirmed that by modulating the inflammatory response in the early stages, somehow the disease is better managed’.

PREGLIASCO: ‘NO TO CORTISONE RIGHT AWAY’

Pregliasco points out that ‘many colleagues give cortisone right away, but it has negative effects, it has a more massive anti-inflammatory action, but it is inappropriate.

Cortisone is good at times when the oxygen percentage is low.

The moment this more powerful weapon is used, we are faced with other side effects’.

‘Therefore,’ the expert points out regarding the study published in the ‘Lancet’, ‘we can speak of a consolidation that must not be a reversal of an approach that leads us to agree with all those colleagues who, instead, think we can always recover from the disease’.

WATCHFUL WAITING AS PATIENT MONITORING

Pregliasco continues: “What was always said was ‘watchful waiting’, mocked as a definition even though it is actually patient monitoring.

In the emergency phases, because of fears, because there were too many people, we were unable to manage the first cases.

Moreover, because as always, the therapies are consolidated as the caseload increases. And here it has increased a lot’.

‘So,’ concludes the virologist of the Milan State University, ‘I stress that this does not mean abjuring what were the first indications on the use of anti-inflammatories.

It is true that tachypirin, compared to acetylsalicylic acid and other NSAIDs, has a mainly anti-fever action, while aspirin itself or others have a more transversal anti-inflammatory action’.

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Agenzia Dire