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Background <p>The global epidemic of novel coronaviruses remains severe, and COX-2 selective inhibitors have attracted attention due to their promising clinical potential.</p> Methods <p>Pertinent articles published up to 1 April 2025 were systematically searched and retrieved, including randomized controlled trials and cohort studies. To assess the efficacy of COX-2 selective inhibitors versus other NSAIDs, we analysed five aspects, including death, mechanical ventilation, ICU admission, oxygen uptake, and composite adverse effects.</p> Results <p>The results showed that COX-2 selective inhibitors significantly reduced the risk of death, with third-highest SUCRA ranking. Regarding the risk of mechanical ventilation, COX-2 inhibitors were associated with a reduced risk and ranked first according to SUCRA compared with other interventions. COX-2 inhibitors were also effective in reducing the risk of ICU admission and endotracheal intubation, again ranking first by SUCRA. In addition, COX-2 inhibitors demonstrated therapeutic potential in reducing the risk of composite adverse effects compared with other NSAIDs.</p> Conclusion <p>Although this study shows that COX-2 inhibitors have good promise for the treatment of COVID-19, there is still a lack of high-quality RCTs to support the conclusions, and there is still room for improvement.</p> Trial registration <p>(PROSPERO. CRD CRD42023445987)</p> The clinical trial number <p>Not applicable.</p>

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Comparison of the efficacy and safety of selective COX-2 inhibitors and non-steroidal anti-inflammatory drugs in the treatment of COVID-19 patients: a systematic review and network meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月21日

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  • Di Wu,
  • Yiting Li,
  • Peixv Chen,
  • Ke Zhu,
  • Chao Cao

摘要

Background

The global epidemic of novel coronaviruses remains severe, and COX-2 selective inhibitors have attracted attention due to their promising clinical potential.

Methods

Pertinent articles published up to 1 April 2025 were systematically searched and retrieved, including randomized controlled trials and cohort studies. To assess the efficacy of COX-2 selective inhibitors versus other NSAIDs, we analysed five aspects, including death, mechanical ventilation, ICU admission, oxygen uptake, and composite adverse effects.

Results

The results showed that COX-2 selective inhibitors significantly reduced the risk of death, with third-highest SUCRA ranking. Regarding the risk of mechanical ventilation, COX-2 inhibitors were associated with a reduced risk and ranked first according to SUCRA compared with other interventions. COX-2 inhibitors were also effective in reducing the risk of ICU admission and endotracheal intubation, again ranking first by SUCRA. In addition, COX-2 inhibitors demonstrated therapeutic potential in reducing the risk of composite adverse effects compared with other NSAIDs.

Conclusion

Although this study shows that COX-2 inhibitors have good promise for the treatment of COVID-19, there is still a lack of high-quality RCTs to support the conclusions, and there is still room for improvement.

Trial registration

(PROSPERO. CRD CRD42023445987)

The clinical trial number

Not applicable.