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Is taking ibuprofen to combat COVID-19 symptoms a risk?

Ibuprofen and other NSAIDs may hurt not help

Isabell Rivera OW Contributor | 5/7/2020, midnight

As the pandemic, caused by the novel coronavirus (COVID-19), continues to rise, rumors have circled the internet that ibuprofen might actually worsen the symptoms of COVID-19.

On March 14, French health minister Olivier Véran tweeted that taking nonsteroidal anti-inflammatory drugs (NSAIDs)—such as ibuprofen, which help reduce fever and body aches—could aggravate the symptoms of COVID-19 and advised to take paracetamol instead. Paracetamol is the European, generic name for the drug acetaminophen, which is known by the brand name Tylenol in the U.S.

According to the BBC, Paul Little, a professor of primary care research at the University of Southampton, England, said that research done on other respiratory infections has shown that the use of NSAIDs is linked to further complications, since the drug may lower the body’s immune response.

However, according to the National Institute of Allergy and Infectious Diseases, more research needs to be done and at the moment there is “no evidence that ibuprofen increases the risk of serious complications or of acquiring the virus that causes COVID-19.”

The World Health Organization (WHO) has not released any recommendations on whether or not to use ibuprofen, or other painkillers, to combat COVID-19 symptoms.

“WHO is aware of concerns on the use of non-steroidal anti-inflammatory drugs (i.e., ibuprofen) for the treatment of fever for people with COVID-19,” Tarik Jasarevic, the WHO spokesperson told CNN. “WHO is gathering further evidence on this issue before making a formal recommendation, but after a rapid review of the literature, is not aware of published clinical or population-based data on this topic.”

Many physicians and medical assistants, however, say that ibuprofen works just fine.

Dr. Branden Turner, a family medicine physician at the Kaiser Permanente West Los Angeles Medical Center, said that the initial rumor was based on an observational study from China, stating that NSAIDs may worsen the course of the coronavirus, but ultimately concluding that more research was needed.

“After the French health ministry released a statement in mid-March against the use of ibuprofen and other non-steroidal anti-inflammatories (NSAIDs), there have been many rumblings about its use in the setting of coronavirus,” Turner said. “The World Health Organization (WHO) released a scientific brief on April 19 based on a review of 73 studies looking at adverse outcomes of coronavirus patients with the use of anti-inflammatories. At this time, the WHO does not recommend the usage of ibuprofen or other NSAIDs in the setting of coronavirus. Hopefully, more research is yet to come.”

In New York City, where COVID-19 hit hard, health practitioners and registered nurses agree that ibuprofen helps with body aches and fever, more so than Tylenol does. However, some patients might be sensitive to NSAIDs.

“There is some research that ibuprofen is contraindicated in COVID-19 patients, who are critically ill (intubated and vented) but not for mild and moderate cases,” said Sarah Fisher, a registered nurse of interventional radiology at NYU Langone Hospital in Brooklyn, NY.

Other experts suggest that Véran’s advice on drugs, such as ibuprofen, is aligned with regulations of painkillers in some European countries, although there might not be a direct link to COVID-19 since there isn’t scientific proof that states the opposite.

“There is a good reason to avoid ibuprofen as it may exacerbate acute kidney injury brought on by any severe illness, including severe Covid-19 disease. There isn't yet any widely accepted additional reason to avoid it for Covid-19,” said Rupert Beale, a group leader in cell biology of infection at the UK's Francis Crick Institute, CNN reported.

Due to the lack of scientific evidence regarding the effects of NSAIDs and COVID-19 symptoms, European researchers argue to not risk it, and to take acetaminophen instead.

According to BMJ, a British medical journal, the tweet sparked by Véran might have been ignited by an incident in southwest France. Four young COVID-19 patients, who had no other health-related issues, developed serious symptoms after taking NSAIDs in the early stages, an infectious disease doctor reported.

“COVID-19, research is needed into the effects of specific NSAIDs among people with different underlying health conditions. In the meantime, for treating symptoms such as fever and sore throat, it seems sensible to stick to paracetamol as first choice,” said Charlotte Warren-Gash, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine.