Does Ibuprofen Worsen Coronavirus Infection

Executive Summary

• There have been concerns that ibuprofen and other anti-inflammatory drugs will worsen COVID-19 infection.

• This was raised as a theoretical problem in a letter to Lancet. No data was provided to support this concern.

• This issue has been reinforced by the WHO and the French Health Minister making many individuals want to stop these drugs.

• There is no reason for thinking that ibuprofen will worsen COVID-19 and no immediate need to change your treatment. You should contact your doctor before changing any medicines.

There have been several questions about the recent reports that ibuprofen treatment for arthritis or other conditions would be “risky” for patients with coronavirus infection. The short answer is there is no data to support this theory but since it is recently been reiterated by the World Health Organization and the French Minister of health I would like to spend a little more time explaining why people should ignore a recommendation to discontinue these drugs.

This whole issue arose due to a letter was published in the journal Lancet.

It raised a theoretical concern that nonsteroidal, anti-inflammatory drugs (NSAID) such as Motrin and Alleve would increase the expression of a protein called ACE2; the receptor protein for the virus and this could worsen infection. There was no data to support this theory and certainly no evidence in either cell cultures, animal models or humans showing that coronavirus infection was worsened by taking drugs like ibuprofen or aspirin. Lancet is a journal that often publishes provocative theories; the worst example of this was a paper that suggested vaccines cause autism. This letter is simply an hypothesis about a theoretical concern. The fact that the WHO has now endorsed this is maddening and detracts from the. real issues patients are facing with this pandemic.

While it may be fine to take acetaminophen/Tylenol instead of NSAID for low-grade fever, these drugs also have side effects and in high doses can cause liver damage. I have heard of patients who are on immunosuppressive drugs for diseases like arthritis who’s doctors reduced these drugs due to infectious concerns about coronavirus; instead they have been using more NSAID. This is a real concern, and should not allow substitution of Tylenol or acetaminophen for the NSAID.

Therefore, if you’re on anti-inflammatory drugs like ibuprofen that are prescribed by your doctor for a specific reason please talk to your doctor before you consider changing the medicines. The theoretical risk from NSAID is minimal compared to the problems that could occur from changing your medicines.