{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T12:31:59Z","timestamp":1768307519291,"version":"3.49.0"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003718","name":"Korea Institute of Oriental Medicine","doi-asserted-by":"publisher","award":["KSN2121220"],"award-info":[{"award-number":["KSN2121220"]}],"id":[{"id":"10.13039\/501100003718","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Long coronavirus disease (COVID) poses a significant burden following the coronavirus disease 2019 (COVID-19) pandemic. Debate persists regarding the impact of nonsteroidal anti-inflammatory drug (NSAID) administration during acute-phase COVID-19 on the development of long COVID. Hence, this study aimed to assess the potential association between NSAID use and long COVID using data from patients with COVID-19 in Korea\u2019s National Health Insurance Service.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This nested case-control study defined the study cohort as patients diagnosed with COVID-19 for the first time between 2020 and 2021. The primary exposure investigated was NSAID prescriptions within 14 days of the initial COVID-19 diagnosis. We used propensity score matching to create three control patients matched to each patient in the NSAID exposure group. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated after the adjustment for demographics, Charlson Comorbidity Index, and existing comorbidities.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among the 225,458 patients diagnosed with COVID-19, we analyzed data from 254 with long COVID. The adjusted OR (aOR) for NSAID exposure during acute-phase COVID-19 was higher in long COVID cases versus controls (aOR, 1.79; 95% CI, 1.00\u20133.19), suggesting a potential relationship. However, a sensitivity analysis revealed that the increased odds of NSAID exposure in the acute phase became statistically non-significant (aOR, 1.64; 95% CI, 0.90\u20132.99) when COVID-19 self-quarantine duration was included as a covariate. Additionally, acetaminophen exposure was not significantly associated (aOR, 1.12; 95% CI, 0.75\u20131.68), while antiviral drugs demonstrated a stronger association (aOR, 3.75; 95% CI, 1.66\u20138.48).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Although this study suggests a possible link between NSAID use in the acute COVID-19 infection stage and a higher risk of long COVID as well as both NSAID and acetaminophen use during the chronic COVID-19 period and a lower risk of long COVID, the association was not statistically significant. Further research is needed to determine the causal relationship between the various treatment options for acute COVID-19 and the development of long COVID.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312530","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T18:30:52Z","timestamp":1732300252000},"page":"e0312530","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Association between long COVID and nonsteroidal anti-inflammatory drug use by patients with acute-phase COVID-19: A nationwide Korea National Health Insurance Service cohort study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6127-5401","authenticated-orcid":true,"given":"Ye-Seul","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5907-6059","authenticated-orcid":true,"given":"Heejun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0942-8164","authenticated-orcid":true,"given":"Sunoh","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8448-3219","authenticated-orcid":true,"given":"Tae-Hun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"issue":"7","key":"pone.0312530.ref001","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.cmi.2022.02.018","article-title":"ESCMID rapid guidelines for assessment and management of long COVID","volume":"28","author":"D Yelin","year":"2022","journal-title":"Clinical Microbiology and Infection"},{"key":"pone.0312530.ref002","first-page":"374","article-title":"Long covid\u2014mechanisms, risk factors","author":"H Crook","year":"2021","journal-title":"and management. bmj"},{"issue":"1","key":"pone.0312530.ref003","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12879-022-07062-6","article-title":"Post-acute COVID-19 syndrome in patients after 12 months from COVID-19 infection in Korea.","volume":"22","author":"Y Kim","year":"2022","journal-title":"BMC infectious diseases."},{"issue":"2","key":"pone.0312530.ref004","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.cell.2020.02.052","article-title":"SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor","volume":"181","author":"M Hoffmann","year":"2020","journal-title":"cell"},{"issue":"11","key":"pone.0312530.ref005","doi-asserted-by":"crossref","first-page":"e4179","DOI":"10.1093\/cid\/ciaa1056","article-title":"Association between nonsteroidal antiinflammatory drug use and adverse clinical outcomes among adults hospitalized with coronavirus 2019 in South Korea: a nationwide study","volume":"73","author":"HE Jeong","year":"2021","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0312530.ref006","article-title":"National Health Insurance Statistical Yearbook.","author":"Y-IK Sun-Min Kim","year":"2020","journal-title":"Health Insurance Review & Assessment, National Health Insurance Service Korea"},{"issue":"3","key":"pone.0312530.ref007","doi-asserted-by":"crossref","first-page":"146","DOI":"10.4082\/kjfm.20.0062","article-title":"Conducting and Reporting a Clinical Research Using Korean Healthcare Claims Database.","volume":"41","author":"S Kim","year":"2020","journal-title":"Korean J Fam 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COVID: lights and shadows on the clinical characterization of this emerging pathology.","volume":"47","author":"V Cogliandro","year":"2024","journal-title":"The new microbiologica."},{"key":"pone.0312530.ref015","article-title":"Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists","author":"M. Day","year":"2020","journal-title":"British Medical Journal Publishing Group"},{"issue":"2","key":"pone.0312530.ref016","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1378\/chest.09-3102","article-title":"Nonsteroidal antiinflammatory drugs may affect the presentation and course of community-acquired pneumonia.","volume":"139","author":"G Voiriot","year":"2011","journal-title":"Chest"},{"issue":"1","key":"pone.0312530.ref017","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/s41533-022-00300-z","article-title":"The use of non-steroidal anti-inflammatory drugs (NSAIDs) in COVID-19.","volume":"32","author":"P Kushner","year":"2022","journal-title":"NPJ Primary Care Respiratory Medicine"},{"issue":"1","key":"pone.0312530.ref018","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s12985-022-01813-2","article-title":"NSAID use and clinical outcomes in COVID-19 patients: a 38-center retrospective cohort study","volume":"19","author":"JT Reese","year":"2022","journal-title":"Virology journal"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0328398","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T18:31:01Z","timestamp":1732300261000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312530"}},"subtitle":[],"editor":[{"given":"Seth Kwabena","family":"Amponsah","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,22]]},"references-count":18,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0312530","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,22]]}}}