Assessment of Efficacy of Nimesulide in the Treatment of COVID-19 Infection

Objective: There are different anti-inflammatory drugs that are being used in patients with moderate to severe COVID-19 infection. However, in mild to moderate COVID-19 infection, Nimesulide treatment might impede the inflammation with a superior safety profile. Therefore, this study is intended to assess the anti-inflammatory, analgesic and antipyretic activity of Nimesulide in mild to moderate Covid-19 infection.

Methodology: This was an uncontrolled longitudinal study conducted at Pakistan Institute of Medical Sciences Islamabad. The duration of the study was about six months. A total of 66 patients were enrolled. All the patients received Nimesulide 100 mg along with 10 ml sucralfate suspension two times a day for five days. Patients with elevated C-reactive protein or further comorbidities were prescribed 250 mg azithromycin two times a day for five days. Patients with elevated D-dimer (above 500) or other comorbidities were prescribed enoxaparin in a dose of 60 mg subcutaneously once daily for five days. The Primary outcome was estimated in terms of a percent change in oxygen saturation, hospitalization, or death.

Results: The results showed that 31(47.0%) were females and 35(53.0%) were males. The mean oxygen saturation on presentation was 93%±7.9. 24(36.36%) of the patients had D-dimer levels < 250 ng/ml, while 30(45.45%) of the patients had D-dimer levels >250 ng/ml with significant difference between them (p=0.025). 16(24.24%) patients received enoxaparin while 49(74.24%) patients did not received enoxaparin and found a significant difference between the mean change in oxygen saturation of them (p<0.001). 47(71.2%) patients received azithromycin while 19(28.8%) patients did not received azithromycin and found a significant difference between the mean change in oxygen saturation of them (p=0.03).

Conclusion: This study concluded that Nimesulide treatment resulted in a rapid temperature fall within five days. Furthermore, oxygen saturation was also significantly improved in patients treated with Nimesulide.