Журнал «Медицина неотложных состояний» Том 19, №3, 2023

Літературний огляд присвячений аналізу результатів досліджень ефективності й безпеки використання нeстероїдних протизапальних препаратів (НПЗП) у програмах інтенсивної терапії пацієнтів з COVID-19, проведених у 2020–2021 роках. Застосовані за іншими показаннями НПЗП або аспірин у низьких дозах не підвищують чутливість організму до SARS-CoV-2 і не є додатковими факторами ризику тяжкості перебігу COVID-19 і смерті від нього. Отже, у пацієнтів, які отримують НПЗП або аспірин у низьких дозах для лікування коморбідних станів, ці препарати не повинні відмінятися і можуть застосовуватись під час лікування COVID-19. Зараз встановлено, що прозапальний ефект під час перебігу SARS-CoV-2 зумовлюють простагландини. Пригнічення їх продукції за допомогою НПЗП може давати позитивний ефект під час початкової фази вірусної інфекції — перед розвитком гострого респіраторного дистрес-синдрому. На сьогодні не встановлено клінічних переваг низьких доз аспірину для первинного запобігання тромботичним ускладненням у госпіталізованих хворих з COVID-19, тому з цією метою аспірин застосовувати не рекомендують.

The literature review deals with the analysis of the results of studies on the effectiveness and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) in the intensive care programs for patients with COVID-19 in 2020–2021. NSAIDs used for other indications or low-dose aspirin do not increase the body’s sensitivity to SARS-CoV-2 and are not additional risk factors for the severity of the course and mortality from COVID-19. Therefore, in patients receiving NSAIDs or low-dose aspirin for comorbid conditions, these drugs should not be withdrawn and may be used during the treatment of COVID-19. It has now been clarified that the pro-inflammatory effect in SARS-CoV-2 is caused by prostaglandins. Suppression of their production with the help of NSAIDs can have a positive effect during the initial phase of a viral infection, before the development of acute respiratory distress syndrome. To date, the clinical benefits of low-dose aspirin for the primary prevention of thrombotic complications in hospitalized patients with COVID-19 have not been proven, and therefore it is not recommended to use aspirin for this purpose.

СOVID-19; нестероїдні протизапальні препарати; циклооксигенази; аспірин; простагландини; арахідонова кислота; антикоагулянтна терапія

СOVID-19; non-steroidal anti-inflammatory drugs; cyclooxygenases; aspirin; prostaglandins; arachidonic acid; anticoagulant therapy

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