Is taking ibuprofen actually risky for COVID-19 patients?
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Update: As of March 19, the World Health Organization has updated their stance on the use of ibuprofen, saying that based on currently available information, they “do not recommend against the use of ibuprofen.”
In a thread on Twitter, WHO said they are aware of the concerns around using ibuprofen for treating patients’ fever. “We are consulting with physicians treating the patients and are not aware of reports of any negative effects, beyond the usual ones that limit its use in certain populations,” they said.
The original story from March 18 follows:
Fever-reducing medicine such as ibuprofen could worsen COVID-19, top health officials say.
The World Health Organization (WHO) is recommending as of Tuesday that people suffering from symptoms of the illness avoid taking the common anti-inflammatory painkiller, which is known by brand names like Advil and Motrin.
Instead, WHO says people who suspect they have COVID-19 (the name of the illness caused by novel coronavirus) and who need symptom relief take paracetamol, better known in Canada and the U.S. as acetaminophen (brand name Tylenol).
The recommendation came after French officials warned that anti-inflammatory drugs could exacerbate effects of the virus.
France’s health minister Olivier Veran recently tweeted that "taking anti-inflammatory drugs (ibuprofen, cortisone...) could be an aggravating factor of the infection. If you have a fever, take paracetamol. If you are already on anti-inflammatory drugs or in doubt, ask your doctor for advice."
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The French Ministry of Social Affairs and Health also issued an alert saying that "grave adverse effects" linked to the use of non-steroidal anti-inflammatory drugs (NSAIDs) (a family of drugs that includes ibuprofen) have "been identified with patients affected by COVID-19, in potential or confirmed cases.
"We repeat that the treatment of a fever or of pain linked to COVID-19 or to any other respiratory viral disease should be paracetamol," the government’s urgent notice said.
Veran’s warning followed the recent publication of a study in the Lancet medical journal that hypothesized that an enzyme boosted by anti-inflammatory drugs such as ibuprofen could facilitate and worsen COVID-19 infections.
While advising people with COVID-19 avoid ibuprofen, WHO stated that health experts are still looking into the matter to provide “further guidance.”
B.C. provincial health officer Dr. Bonnie Henry says that while more evidence is needed, clinical experts in Canada are closely following research and development.
“We have seen that with other febrile illnesses; sometimes things like aspirin can cause a flare-up in immune system, so it’s biologically plausible,” that ibuprofen could aggravate COVID-19, Henry said at a press briefing on Tuesday.
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Although ibuprofen is commonly used to treat fevers generally, “plain Tylenol or acetaminophen would be an alternative,” Henry said.
Ibuprofen’s anti-inflammatory properties could “dampen down” the immune system and slow down the recovery process, Ian Jones, a professor of virology at the University of Reading told the British Medical Journal. He noted that based on similarities between the novel coronavirus and SARS, it’s likely COVID-19 reduces a key enzyme that helps regulate the water and salt concentration in the blood and could contribute to the pneumonia seen in extreme cases.
“Ibuprofen aggravates this, while paracetamol does not,” he said.
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