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The relation between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and severity of COVID-19 has been the subject to debate since the outbreak of the pandemic. Despite speculations about the possible harmful or protective effects, the position currently most supported by the scientific community is that there is no association between use of NSAIDs and COVID-19 outcomes. With the aim of contributing to increase the body of evidence on this issue, we conducted a case–control study using real-world data to investigate the association between prior use of NSAIDs, by active ingredient and type (traditional NSAIDs and selective COX-2 inhibitors), and important COVID-19-related outcomes, including susceptibility, PCR + patient progression, and hospitalisation. Our findings suggest that, in general, the use of traditional NSAIDs is not associated with any adverse COVID-19 outcome. However, we observed a possible association between diclofenac and a higher risk of PCR + patient progression. Our results also suggest that selective COX-2 inhibitors might be related with a reduction in the risk of PCR + patient progression. These results suggest that, with the possible exception of diclofenac, the use of NSAIDs should not be advised against for relief of symptoms in patients with COVID-19. In addition, they support the importance of continue to investigate the treatment potential of selective COX-2 inhibitors in the management of COVID-19, something that could have significant implications for the treatment of this disease and other viral infections. [ABSTRACT FROM AUTHOR]

Introduction: Owing to controversy information surrounds effect of glucocorticoids on the evolution of COVID-19, we evaluate the effects of outpatient glucocorticoid use on the severity and progression of COVID-19 and risk of infection and analyse the effect of window of exposure and dose. Methods: We conducted a population-based case − control study, involving 4 substudies: (i) Hospitalisation; (ii) Mortality, using subjects hospitalised with a PCR + as cases and subjects without a PCR + as controls; (iii) Progression, including subjects with a PCR + (hospitalised versus non-hospitalised); and (iv) Susceptibility, with all subjects with a PCR + and subjects without a PCR +. Adjusted odds ratios (ORa) and their 95% confidence intervals (95% CI) were calculated. Results: The outpatient glucocorticoid use was associated with an increased risk of hospitalisation (aOR 1.79; 95% CI 1.56–2.05), mortality (aOR 2.30; 95% CI 1.68–3.15), progression (aOR 1.69; 95% CI 1.43–2.00) and susceptibility (aOR 1.29, 95% CI 1.19–1.41). Furthermore, the effects was observed to be greater at higher doses and the closer that drug use approached the outcome date, with an almost fourfold increase in mortality among users in the previous month (aOR 3.85; 95% CI 2.63–5.62). Conclusions: According to the results of this real-world data study, outpatient glucocorticoid use should be considered in making decisions about intrahospital treatment. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of prior chronic treatment with angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin-receptor blockers (ARBs), both as a group and by active ingredient, on severity (risk of hospitalization and mortality), progression of and susceptibility to COVID-19. Methods: We conducted a multiple population-based case–control study in Galicia (north-west Spain). The study data were sourced from medical, administrative and clinical databases. We assessed: (1) risk of hospitalization, by selecting all patients hospitalized due to COVID-19 with PCR + as cases, and a random sample of subjects without a PCR + as controls; (2) COVID-19 mortality risk; (3) risk of disease progression; and (4) susceptibility to SARS-CoV-2, considering all patients with PCR + as cases, and the same subjects used in the previous model as controls. Adjusted odds ratios (aORs) were calculated. Results: ACEIs and ARBs were shown to decrease the risk of hospitalization (aOR = 0.78 [95%CI 0.69–0.89] and aOR = 0.80 [95%CI 0.72–0.90] respectively), risk of mortality (aOR = 0.71 [95%CI 0.52–0.98] and aOR = 0.69 [95%CI 0.52–0.91] respectively), and susceptibility to the virus (aOR = 0.88 [95%CI 0.82–0.94] and aOR = 0.92 [95%CI 0.86–0.97] respectively). By active ingredient: use of enalapril was associated with a significantly lower risk of hospitalization (aOR = 0.72 [95%CI 0.61–0.85]), mortality (aOR = 0.59 [95%CI 0.38–0.92]) and susceptibility to COVID-19 (aOR = 0.86 [95%CI 0.79–0.94]); and use of candesartan was associated with a decreased risk of hospitalization (aOR = 0.76 [95%CI 0.60–0.95]), mortality (aOR = 0.36 [95%CI 0.17–0.75]) and disease progression (aOR = 0.73 [95%CI 0.56–0.95]). Conclusion: This large-scale real-world data study suggest that enalapril and candesartan are associated with a considerable reduction in risk of severe COVID19 outcomes. [ABSTRACT FROM AUTHOR]

Objective: To describe the implementation of a pilot Telepharmacy project (TELEA-Farmacia) in adult patients with cancer, analyze the results obtained, and identify opportunities for improvement, from a hospital  pharmacy service., Method: Between October and December 2021, oncology patients, collecting  their oral antineoplastic drugs at the Unit of Oncology Pharmacy of the hospital pharmacy service were stratified using the MAPEX model. Oncology patients  candidates for inclusion in the TELEA-Farmacia project included "medium-high  priority" hospital pharmacy patients, along with oncology patients who,  according to pharmacist's opinion, could benefit from Telepharmacy. On a  weekly basis, oncology patients recorded on the TELEA platform their biological  measurements and completed the questionnaires on medication  adherence and pain. Questionnaires on quality of life were completed on a  monthly basis. To score health indicators, oncology patients accessed TELEA  through the SERGAS-MOBIL app or a web browser. Follow-up of health  indicators was performed by the Unit of Oncology Pharmacy of the hospital  pharmacy service., Results: The study sample included 29 oncology patients (48% were male)  with a mean age of 59 years (44-75). According to the stratification model,  31% were low-priority patients, 62% had medium-priority, and 7%  had high  priority. The digital gap in patients with advanced ages was the main obstacle  to inclusion. Reports were monitored daily, and a total of 364 responses were  received. In the presence of alarming reports and/or out-of-range values,  active monitoring and/or telephonic follow-up were initiated. Pharmaceutical  care was adapted to the health problem detected according to individual  patient needs., Conclusions: The Telemedicine pilot project TELEA-Farmacia made it possible  to test TELEA in patients with cancer in a real-life context. TELEA facilitated  continuous follow-up, early detection of drug-related problems, and the  identification of new needs and improvement points. To such purpose, clinical  oncology pharmacists combined face-to-face consults with patient stratification  and remote follow-up. This study demonstrated that new  stratification models are necessary in hospital pharmacy services to identify  patients with technology skills who can benefit from using Telemedicine tools  as TELEA., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)