When I was in the Philippines in February, I had an upper respiratory infection. I don’t usually get sick, but I guess my body is not immune to the viruses there. At that time, there were only 3 cases of Covid-19, and they were far from me. Two are imported from China, and one local.
I don’t think I had Covid-19.
My illness was about 3 on a scale of 10, with 10 being the worse. Just some stuffy nose, sinus headache, but no fever. Nothing major.
I don’t usually take medicines, but I took Ibuprofen 400 mg to relieve my headache one day.
Half an hour after I took the Ibuprofen, I felt worse. I was surprised at how fast it happened. I went from a 3 to a 7. I felt terrible all over, and my throat and nose got worse. My voice got hoarse.
It took 2 weeks to get better. I wore an N95 mask throughout my flight back. I was at JFK airport for 6 hours, and I’m the only one wearing a mask. I thought that’s interesting.
Then on Mar 17, I read this news, a 4-year-old’s coronavirus symptoms worsen after taking Ibuprofen.
Inside the report is a Tweet by the French Health Minister Olivier Véran Saturday, on Mar 14 where he said,
“Taking anti-inflammatories (ibuprofen, cortisone…) could be an aggravating factor for the infection,” Véran tweeted.
“In case of fever take paracetamol. If you are already on a course of anti-inflammatories or if you are in doubt then consult your doctor,”
One reason is that Ibuprofen is a non-steroidal anti-inflammatory (NSAID). It prevents inflammation. An inflammatory response is necessary to fight any infections.
There was also a recent Letter to the Lancet about the possibility of Ibuprofen increasing the number of ACE2 receptors in the respiratory tract.
ACE2 receptors are where the SARS-Cov-S virus attaches and cause Covid-19 disease. Theoretically, the more receptors for the virus to connect to, the more virus can infect.
Searching around the internet revealed more information about NSAIDs and infections.
France’s National Agency for the Safety of Medicines and Health Products
Further research on the internet showed that France’s National Agency for the Safety of Medicines and Health Products (ANSM) published a warning about the use of NSAIDs in patients suffering from infectious diseases in 2019.
ANSM issued the warning after analyzing almost 20 years of real-world safety data using the NSAIDs ibuprofen and ketoprofen. They found out that NSAIDs worsen the course of an infection.
ANSM recommended that NSAIDs should only be given for pain and NOT for fever. French doctors were told not to treat illnesses or infections with NSAIDs.
The Ministry of Health of France
The website of the Ministry of Health of France has a page for its recommendations about Covid-19.
3- Use of NSAIDs in patients with Covid-19
Serious adverse events related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported in patients with COVID19, possible or confirmed cases.
We remind you that the treatment of a poorly tolerated fever or pain in the context of COVID19 or any other respiratory virosis is based on paracetamol, without exceeding the dose of 60 mg / kg / day and 3 g / day.
NSAIDs should be banned.
Conversely, patients on corticosteroids or other immunosuppressants for a chronic pathology should not interrupt their treatment, unless otherwise advised by the doctor who follows them for this pathology.
This recommendation must be widely disseminated to all health professionals.
The highlights are mine.
British Medical Journal
The British Medical Journal has an article on Mar 17, Covid-19: Ibuprofen should not be used for managing symptoms, say doctors and scientists. In it, they quoted several doctors like Paul Little, a professor of primary care research at the University of Southampton,
“that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used—both respiratory or septic complications and cardiovascular complications.”
Ian Jones, a professor of virology at the University of Reading, said ibuprofen could.
“dampen down” the immune system, which could slow the recovery process.
Charlotte Warren-Gash, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine, said
“For 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.”
Acetaminophen (Tylenol) is called paracetamol in the U.K.
National Institute of Allergy and Infectious Diseases
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, answered the question about NSAIDs in a JAMA Network question and answer video.
“I have not seen any firm data to indicate there is a problem or prove there is not a problem,” he said.
He also said physicians widely believe Tylenol is best for reducing fever if that is the treatment’s primary goal.
The WHO had 2 opposite recommendations in 2 days
On Mar 17, it was reported that WHO spokesman Christian Lindmeier told reporters in Geneva that the UN health agency’s experts were…
“looking into this to give further guidance. In the meantime, we recommend using rather paracetamol, and do not use ibuprofen as a self-medication. That’s important”.
He added that if Ibuprofen had been “prescribed by the healthcare professionals, then, of course, that’s up to them.”
The next day, the WHO said the opposite. In its Tweet,
Q: Could #ibuprofen worsen disease for people with #COVID19?
A: Based on currently available information, WHO does not recommend against the use of of ibuprofen.
The double negative phrase “does not recommend against” of the WHO means it is ok to use Ibuprofen for Covid-19.
“No Evidence”
Looking further around the internet, some physicians think that there is no firm scientific evidence that Ibuprofen can aggravate Covid-19.
The lack of research directly linking NSAIDs and Covid-19 is understandable since the Covid-19 pandemic has only been since December 2019.
It has infected more than 244 thousand people on seven continents in three months and killed more than 10 thousand.
All efforts and money at this time should be focused on testing and definitive treatment.
What we know is that Covid-19 is a viral infection and that NSAIDs are bad for viral infections.
Other Side Effects of NSAIDs
NSAIDs are contraindicated in coronary artery disease CAD. They can worsen heart failure. Patients with CAD and heart failure have a higher death risk if they have Covid-19. More so if the heart failure is decompensated.
NSAIDs can also lead to kidney failure, especially if a person is not drinking enough fluids. Poor appetite is prevalent when someone is sick.
What should I do?
I can’t tell anyone what to do since I don’t give medical advice on the internet. I laid out the information, and it is up to the reader to decide after consulting with their doctors.
The Covid-19 pandemic can spread faster and can kill more than influenza. I want to stack the odds in my favor so that I will survive if I get it.
I know what I will do.
I won’t take any NSAIDs if I get an infection again.
Don’t Get Sick!
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