Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The ibuprofen COVID-19 paradox

Amy G. Schade, PA-C
Conditions
November 21, 2020
Share
Tweet
Share

With the surge of information surrounding COVID-19 released in the news this year, an interesting concern arose regarding ibuprofen’s use in patients with COVID-19. In March of 2020, French authorities were the first to investigate anecdotal reports of severe COVID-19 infection in patients who had taken ibuprofen.

The initial concern involved the ACE-2 receptor. The theoretical concern was that NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen might upregulate this receptor (a known target for cell penetration of the COVID-19 virus), leading to a more severe infection. When this information initially hit the news, many health care providers started recommending acetaminophen instead of NSAIDs to patients with suspected COVID-19 infection. Although well-intentioned, it appears now this idea was misguided.  New research shows that Ibuprofen does not show any correlation with the worsening severity of COVID-19 infection.  A cohort study using Danish health registry data published in September 2020 showed no increase risk in adverse outcomes or 30-day mortality in patients with COVID-19 who used NSAIDs.

Although this link between Ibuprofen and worsening COVID-19 infection has not been demonstrated in the current published data, there likely was some anecdotal evidence to suggest a worsening of symptoms in patients with COVID-19 who used Ibuprofen. It’s possible that the anecdotal reports are not due to the ACE-2 receptor theory but instead, reducing the natural fever response caused a decrease in the immune response, leading to a more severe COVID-19 infection.

In the Danish study published in PLOS Medicine, patients were divided into NSAID users and non-NSAID users. There was no data to track the use of other antipyretics like acetaminophen for symptomatic care, indicating that patients in the control group were likely also treating their fevers, just with non-NSAID medications. Given the ambiguity of these studies, the possible negative effects of using antipyretics in patients with COVID-19 infection is worth further consideration.

It is well known that fevers help to fight infection. For millions of years, humans have evolved with fever as a protective response to infection. Fevers reduce the ability of viruses to replicate in the body and increase immune function through various complex pathways. This begs the question, why do providers routinely recommend treatment of fevers with antipyretic medication?

Fevers rarely cause complications in otherwise healthy patients with viral infections. Ironically this symptomatic care often makes patients feel better temporarily could unknowingly worsen COVID-19 infection outcomes in patients. While the ibuprofen concern regarding COVID-19 has been apparently debunked, it still leaves the larger question yet to be investigated: Could antipyretics be contributing to worse outcomes in patients with COVID-19?

Amy G. Schade is a physician assistant.

Image credit: Shutterstock.com

Prev

How physicians should invest in Bitcoin

November 21, 2020 Kevin 0
…
Next

The 5 "P's" of a pandemic

November 21, 2020 Kevin 0
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
How physicians should invest in Bitcoin
Next Post >
The 5 "P's" of a pandemic

ADVERTISEMENT

Related Posts

  • How to get patients vaccinated against COVID-19 [PODCAST]

    The Podcast by KevinMD
  • COVID-19 divides and conquers

    Michele Luckenbaugh
  • State sanctioned executions in the age of COVID-19

    Kasey Johnson, DO
  • A patient’s COVID-19 reflections

    Michele Luckenbaugh
  • Starting medical school in the midst of COVID-19

    Horacio Romero Castillo
  • COVID-19 shows why we need health insurance

    Jingyi Liu, MD

More in Conditions

  • Coconut oil’s role in Alzheimer’s and depression

    Marc Arginteanu, MD
  • Ancient health secrets for modern life

    Larry Kaskel, MD
  • How the internet broke the doctor-parent trust

    Wendy L. Hunter, MD
  • Mpox isn’t over: A silent epidemic is growing

    Melvin Sanicas, MD
  • How your family system secretly shapes your health

    Su Yeong Kim, PhD
  • The human case for preserving the nipple after mastectomy

    Thomas Amburn, MD
  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...