SHARES
A BMJ article reported doctors and scientists say “do not use ibuprofen to manage symptoms of fever and aches in COVID-19.” Ibuprofen is a common anti-inflammatory and anti-fever medication. It belongs to a group of drugs NSAIDS or non-steroidal anti-inflammatory drugs. Brand names include Nurofen, Advil, Brufen, etc
People showing symptoms of flu or COVID-19 should use paracetamol to relieve symptoms and not ibuprofen. The reason is that should the symptoms turn out to be COVID-19, Ibuprofen might worsen and aggravate the condition.
“If you have fever take paracetamol. Do not use ibuprofen”
For those who use paracetamol to medicate, here is a note of caution. Take Paracetamol strictly according to the dose in your prescription or follow the product information on the package. An overdose of paracetamol causes liver damage.
Warning from French authorities
French Health Minister, Olivier Veran also issued a warning based on reports gathered in France and a recent Lancet Study on ibuprofen. His remarks followed that of a doctor from South West France. The doctor reported four cases of young healthy patients who contracted COVID-19 infection and then progressed on to very serious conditions. All four patients had used an anti-inflammatory drug in the early stage of the symptoms.
A recent study in The Lancet has a theory that an enzyme boosted by anti-inflammatory drugs such as ibuprofen could facilitate COVID-19 infections. This enzyme up regulates ACE receptors in the lung allowing more virus to latch on easily. More studies and research would throw more light on the theory.
Advice from the Experts
Paul Little, Professor at University of Southampton, said that “there was good evidence that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used. This is the case in both respiratory or septic complications and cardiovascular complications.” He added, “The finding in two randomised trials that advise to use ibuprofen results in more severe illness or complications. Hence it helps confirm that the association seen in observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complications.”
Furthermore, Ian Jones, a professor of virology at the University of Reading, said “ibuprofen’s anti-inflammatory properties could “dampen down” the immune system, which could slow the recovery process.” He added that “it was likely, based on similarities between the new virus (COVID-19) and SARS I, that COVID-19 reduces a key enzyme that part regulates 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.
Charlotte Warren-Gash, associate professor at the London School of Hygiene and Tropical Medicine, said: “For COVID-19, we need more research 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.”
Complex role of Anti-Inflammatory drugs in COVID-19
Rupert Beale, an infectious diseases researcher at the Francis Crick Institute, had a warning on cortisone, however. “Patients taking cortisone or other steroids should not stop them except on advice from their doctor,” he said.
As a matter of fact, the immune system plays a complex role in diseases like COVID-19. In China & Italy, an anti-inflammatory drug Actemra (tocilizumab) from Roche is undergoing clinical trials to treat serious complications of COVID-19.
Doctors from a Naples hospital reported they had success using the drug. This drug blocks a key inflammatory molecule interleukin-6. Although this molecule acts as an anti-inflammatory myokine, it also acts as a pro-inflammatory cytokine. Over-secretion of cytokines can trigger a dangerous life threatening syndrome – known as a cytokine storm.
It is currently a speculation, but the drug might prevent fatal “cytokine storms”. In a cytokine storm, the overactivity of the immune system of seriously ill patients can cause multiple organ failure.
More time is necessary for scientists and researches who are racing to find an efficacious drug and vaccine to combat this rapidly explosive pandemic around the world.
Further reads: GetDocSays What Happens When the Coronavirus Invades Our Body?
References:
Find a GP/Family Doctor in Malaysia, on GetDoc
Find a GP/Family Doctor in Singapore, on GetDoc
by Wong Mei Chan
View all articles by Wong Mei Chan.
