Anti-Inflammatory Drug Applications in COVID-19 Management

Severe manifestations of COVID-19 arise not only from viral replication but also from an exaggerated host inflammatory response, commonly termed a cytokine storm. Early landmark studies established that systemic corticosteroids, notably dexamethasone, reduce mortality in patients requiring supplemental oxygen or mechanical ventilation by dampening widespread pulmonary inflammation. Subsequent interventions have targeted specific pathways within the inflammatory cascade. Interleukin-6 receptor antagonists, such as tocilizumab and sarilumab, have demonstrated reductions in progression to respiratory failure when administered to patients with elevated inflammatory markers. Janus kinase inhibitors, including baricitinib, attenuate signalling downstream of multiple pro-inflammatory cytokines and have been incorporated into treatment guidelines for hospitalised patients showing rapid clinical deterioration. Beyond these, repurposed non-steroidal anti-inflammatory drugs (NSAIDs) and leukotriene receptor antagonists have been investigated for early outpatient management, aiming to prevent progression to severe disease. Precision in timing, patient selection and biomarker-driven approaches remains crucial to balance immunosuppression and viral clearance. Overall, anti-inflammatory pharmacotherapy has become integral to a stratified management strategy for COVID-19, reducing mortality and the need for intensive care when deployed according to disease severity and host response.

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Anti-Inflammatory Drug Applications in COVID-19 Management publication trend

The graph below shows the total number of articles in anti-inflammatory drug applications in covid-19 management across all publications each year (not limited to Nature Index journals).

Technical terms

Cytokine storm: An excessive and uncontrolled release of pro-inflammatory cytokines leading to tissue damage and organ dysfunction.

Non-steroidal anti-inflammatory drugs (NSAIDs): A class of drugs that inhibit cyclooxygenase enzymes to reduce production of prostaglandins involved in pain, fever and inflammation.

Interleukin-6 receptor antagonists: Monoclonal antibodies that block IL-6 signalling, thereby mitigating severe inflammatory responses in conditions such as COVID-19.

Janus kinase (JAK) inhibitors: Small molecules that interfere with JAK–STAT intracellular signalling pathways to suppress multiple pro-inflammatory cytokines.

Biomarker-driven therapy: Treatment guided by measurable indicators of disease activity or response, such as serum cytokine levels or acute-phase proteins.

References

1. Ibuprofen, other NSAIDs and COVID-19: a narrative review. Inflammopharmacology (2023).
2. Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial. Pharmaceuticals (2023).
3. Combating pan-coronavirus infection by indomethacin through simultaneously inhibiting viral replication and inflammatory response. iScience (2023).