摘要目的:分析使用非甾体抗炎药(NSAIDs)与新型冠状病毒感染(COVID-19)患者不良预后结局发生风险的关系。方法:以"non-steroidal anti-inflammatory drugs" "NSAIDs" "cox-2 inhibitors" "2019-nCoV" "COVID-19" "SARS-CoV-2" "新型冠状病毒肺炎" "非甾体抗炎药"为主要检索词，采用主题词＋自由词的方法，在PubMed、Embase、Web of Science、中华医学期刊网、中国知网、万方数据库、维普中文期刊服务平台数据库中进行检索。检索时间为建库始至2023年2月。2名研究者按照纳排标准进行文献筛选、质量评价和数据提取，使用Stata 14.0进行meta分析。结果:最终纳入研究12项，总样本量2 571 306例。meta分析结果显示，使用NSAIDs不会增加COVID-19患者死亡、重症COVID-19、入住重症监护病房、急性肾损伤或连续肾脏替代治疗、机械通气、氧疗和因COVID-19住院治疗的发生风险，合并 OR(95% CI)分别为0.81(0.63～1.04)、1.21(0.40～3.64)、1.29(0.84～1.98)、0.90(0.60～1.35)、0.81(0.54～1.21)、0.98(0.88～1.10)、1.11(0.75～1.63)。按照NSAIDs暴露时间进行亚组分析后，结果显示使用NSAIDs与COVID-19患者死亡风险降低有关，确诊COVID-19前、确诊COVID-19后、暴露时间不明3个亚组的 OR(95% CI)分别为0.99(0.98～1.00)、0.69(0.61～0.78)、0.51(0.47～0.56)。敏感性分析表明结果可靠性较好，Egger′s检验和Begg′s检验结果均表明纳入文献不存在发表偏倚。 结论:现有的证据不支持使用NSAIDs会增加COVID-19患者不良预后的发生风险，反之可能会降低患者的死亡风险。

abstractsObjective:To analyze the correlation between the use of non-steroidal anti-inflammatory drugs (NSAIDs) and the risk of adverse outcomes in patients with coronavirus disease 2019 (COVID-19).Methods:Relevant articles published from the beginning of the database construction to February 2023 were searched in the online databases PubMed, Embase, Web of Science, China Medical Journal Network, CNKI, Wanfang Database, and VIP Chinese Journal Service.Using the method of subject words combined with free words, the following key words were searched: non-steroidal anti-inflammatory drugs, NSAIDs, cox-2 inhibitors, 2019-nCoV, COVID-19, SARS-CoV-2, and novel coronavirus pneumonia, non-steroidal anti-inflammatory drugs.Literature screening, quality assessment and data extraction were performed by 2 researchers according to the inclusion and exclusion criteria.Stata 14.0 was used for meta-analysis.Results:Twelve studies involving 2, 571, 306 COVID-19 patients were recruited.Meta-analysis showed that the use of NSAIDs did not increase the risks of death, severe COVID-19 infection, admission to intensive care units, acute kidney injury or continuous kidney replacement therapy, mechanical ventilation, oxygen therapy, and COVID-19-related hospitalization in COVID-19 patients, with pooled OR (95% CI) of 0.81 (0.63-1.04), 1.21 (0.40-3.64), 1.29 (0.84-1.98), 0.90 (0.60-1.35), 0.81 (0.54-1.21), 0.98 (0.88-1.10), and 1.11 (0.75-1.63), respectively.Subgroup analysis based on duration of NSAIDs exposure showed NSAID use was associated with reduced risk of death in COVID-19 patients.The pooled OR (95% CI) of the three subgroups including before COVID-19 diagnosis, after COVID-19 diagnosis, and unknown exposure time were 0.99 (0.98-1.00), 0.69 (0.61-0.78), and 0.51 (0.47-0.56), respectively.In addition, sensitivity analysis showed that theresults were stable and reliable.Egger′s test and Begg′s test showed that there was no publicationbias among the included studies. Conclusions:Existing evidences do not support the fact that the use of NSAIDs will increase the risk of adverse prognosis outcomes in COVID-19 patients.On the contrary, it may reduce the risk of death.