Ibuprofen Making Coronavirus Symptoms Worse? Experts React

On Tuesday while addressing reporters in Geneva, WHO spokesperson Christian Lindmeier announced the organization recommends paracetamol over ibuprofen to self-medicate while treating mild symptoms of COVID-19. He, however, clarified that if ibuprofen was prescribed by doctors themselves, then it’s up to the health practitioners to handle it. 

Concerns regarding ibuprofen were first shared by French doctor Jean-Louis Montastruc on Twitter. "In this period of coronavirus, it is necessary to remember the risk of complications of the NSAIDs in case of fever or infection," he said in his tweet. This was followed by French Health Minister Olivier Véran

's post that was tweeted by him on March 14 saying that taking anti-inflammatory drugs could aggravate the condition. 

Several other tweets warned of increasing the severity of the disease in young and middle-aged people without preexisting conditions, but without any scientific evidence whatsoever. A rumor doing the rounds on Twitter revealed that a lab in Vienna had confirmed that "the vast majority of people who died of COVID-19 had ibuprofen in their system." The online posts were shared further on Whatsapp and voice messages in both German and English, leaving doctors worldwide in a quandary over the right treatment to kill the new invasive pathogen causing a pandemic.

In the United Kingdom, experts came down heavily on the National Health Service (NHS) recommending either paracetamol or ibuprofen to treat symptoms. Since then, the NHS retracted this advice from the website on Tuesday. It was clarified that while they do not have strong evidence that ibuprofen exacerbates the disease, but “until we have more information, take paracetamol to treat the symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you."

Experts Speak

Part of the body’s defense mechanism against infectious viruses is to increase its temperature in order to kill the viruses and bacteria with a fever. While non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol lower the body’s temperature, it does not help in the long run. These medicines distract the body from defeating invaders and hinder the body’s ability to kill viruses, letting the individual stay contagious far longer.

Ibuprofen The WHO advised against people self-medicating with Ibuprofen to treat COVID-19 symptoms amidst concerns that it exacerbates the condition. Chris Smith (edited for size)/CC BY-NC-SA 2.0

"Everything that walks, flies, crawls or swims on the face of this earth makes fever," Dr. Paul Offit, infectious disease expert at the University of Pennsylvania and Children’s Hospital of Philadelphia

, said, reported the New York Times. 

One manufacturer was on the defense. British pharmaceutical company Reckitt Benckiser (RB), which manufactures ibuprofen under the brand name ‘Nurofen’ said they are in touch with WHO and the European Medicines Agency (EMA) for guidance and evaluation on the safety of their products. "We do not currently believe there is any proven scientific evidence linking over-the-counter use of ibuprofen to the aggravation of COVID-19," a statement from the company spokesperson said.

Diabetes and hypertension patients are generally treated with angiotensin-converting enzyme (ACE) inhibitors and angiotensin II type-I receptor blockers (ARBs). This is because pathogenic viruses enter the body by attaching themselves to angiotensin-converting enzyme 2 (ACE2), which the body then tries to ward off and fight with ACE inhibitors. According to a new study published in the Lancet, certain NSAIDs like ibuprofen boost the production of this enzyme instead and worsens COVID-19 infections manifold. 

"We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19," the researchers stated after reviewing three studies of recent COVID-19 patients, some of whom had severe comorbidities and were potentially treated with ACE inhibitors but were not assessed.

"If this hypothesis were to be confirmed, it could lead to a conflict regarding treatment because ACE2 reduces inflammation and has been suggested as a potential new therapy for inflammatory lung diseases, cancer, diabetes, and hypertension," the researchers added further, knowing well that the hypothesis could contradict previously accepted facts. Also, the study was not a randomized controlled trial and is only suggesting a possibility. 

However, other experts could potentially agree with the hypothesis based on previous studies saying that ibuprofen makes respiratory illnesses worse. "There are many studies that suggest ibuprofen use during a respiratory infection can result in worsening of the disease or other complications," Parastou Donyai, PhD, professor at the University of Reading, said. However, she did point out that there is no current evidence to suggest that ibuprofen harms healthy 25-year-olds with COVID-19 symptoms. 

Well, until more research investigates the various aspects of treating COVID-19, physicians and researchers are going to have to agree to disagree. They do not have a choice. 

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