COVID-19 & ibuprofen

Claim: Ibuprofen may worsen the effects of COVID-19 and should be avoided.

There are facts and fiction. Let’s go through what we know, and claims that cannot be substantiated.

Genuine medical advice

The World Health Organization (WHO) recommends avoiding ibuprofen (Advid, Motrin) as it may increase the risk of developing severe and fatal COVID-19:^[1]Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? (Fang, Karakiulakis, & Roth, 2020)

ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19.

We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.

NSAIDs such as ibuprofen were associated with a 50% increased risk of a heart attack after using them for one week or longer.^[2]NSAIDs in Acute Respiratory Infection (Heneghan & Brassey, 2020)

Individual data from four studies of 446,763 individuals including 61,460 with acute myocardial infarction showed that taking any dose of NSAIDs for one week or more was associated with a 50% increased risk of a heart attack.

Odds ratios for increased: Ibuprofen, 1.48 (1.00 to 2.26); Diclofenac, 1.50 (1.06 to 2.04) and Naproxen, 1.53 (1.07 to 2.33).

No research has been conducted on the effects of ibuprofen on COVID-19.

Ibuprofen may worsen some respiratory illnesses.

False stories

The BBC stated that false stories are currently circulating, including:^[3]Coronavirus and ibuprofen: Separating fact from fiction | BBC

• There are four young people in an intensive care unit in Cork who have no underlying illnesses—all were taking anti-inflammatories and there are concerns this has caused a more severe illness. (false)
• The University of Vienna has sent a memo warning people with coronavirus symptoms not to take ibuprofen, “because it has been discovered that it increases the speed of reproduction of the coronavirus COVID-19 in the body and this is the reason why people in Italy have reached the current bad stage and rapid spread.” (false)
• At the university hospital in Toulouse, France, there are four very critical cases of coronavirus in [young people] who do not have any health problems. Their problem is that when they all appeared to have symptoms, they all took painkillers like ibuprofen. (false)

In an upcoming post, I will dispel more myths around COVID-19
in a further attempt to combat and correct misinformation.