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Infectious Diseases

Updated 23 March 2020

WHO not against using ibuprofen for Covid-19 symptoms, but recommends paracetamol as a safer option

There have been concerns that taking medications with anti-inflammatory properties will worsen Covid-19 symptoms, but the WHO has stated that there isn't enough evidence to recommend against the use thereof.

Earlier this week, the World Health Organization (WHO) recommended that people suffering Covid-19 symptoms avoid taking medication with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. This suggestion came after French Health Minister, Olivier Veran, tweeted that, based on a study in the The Lancet medical journal, anti-inflammatory medications could worsen Covid-19 infections.

However, the WHO have since updated their advice, saying that they do not recommend against the use of the medication. This was based on currently available information, they said.

According to Science Alert, WHO spokesman Christian Linmeier said that the UN health agency’s experts were looking into the concern and are seeking to give further guidance on the matter.

“Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to relieve symptoms of headaches, painful periods, sprains and strains, colds and flu, arthritis, and other causes of long-term pain,” explains the NHS website

Panic and confusion following study’s release

When French Minister Veran tweeted that anti-inflammatories such as ibuprofen can be "an aggravating factor" in Covid-19 infections this week, panic ensued and discussions among medical experts quickly followed. The Lancet study he referred to hypothesised that an enzyme, boosted by anti-inflammatory drugs could consequently aggravate Covid-19 infections.

But experts say that currently, there’s simply not enough evidence to warrant this as a conclusion.

"There is currently no scientific evidence establishing a link between ibuprofen and worsening of Covid-19," the European Medicines Agency (EMA) wrote in a statement on 18 March, reports LiveScience.

"The only problem is they [researchers] offer no proof that this actually occurs," Angela Rasmussen, a virologist at Columbia University in New York, explained on Twitter. "And this hypothesis relies on several major assumptions that may not be true."

Instead, the severity of the disease is dependent on many other factors such as the patient’s genetics and general health, Rasmussen added.

To use or not to use?

The NHS has said that while there is no firm evidence that NSAIDs can worsen Covid-19 symptoms, until more credible information becomes available, they advise to err on the side of caution and take paracetamol to treat the symptoms of the new coronavirus instead – unless your doctor advises against its use, reports the BBC

NSAIDs and possible side effects

Although NSAIDs are commonly used, they're not suitable for everyone – and can sometimes cause upsetting side effects, notes the NHS, especially for people with asthma and heart problems.

There are some studies that have found a link between NSAIDs causing complications and severe illness in other respiratory infections, and may "dampen" the body’s immune system, medical experts told the BBC

However, Professor Parastou Donyai at the University of Reading also told the news broadcasting company: "I have not seen any scientific evidence that clearly shows a totally healthy 25 year old taking ibuprofen for symptoms of Covid-19 is putting themselves at additional risk of complications."

For this reason, it’s safe to assume that, according to medical professionals, if you are already taking medications with anti-inflammatory properties for other conditions, you should not stop without consulting their doctor. 

With regard to the topic at hand, until rigorous research on NSAIDs having an effect on the severity of illness caused by the new coronavirus, in both healthy people and those with chronic conditions, becomes available, Linmeier has recommended rather using paracetamol, and not to use ibuprofen as a self-medication.

Similarly, Dr Charlotte Warren-Gash, associate professor of epidemiology at London School of Hygiene and Tropical Medicine, has advised particularly vulnerable patients that "it seems sensible to stick to paracetamol as first choice."

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Image: Ana Maria Serrano/Getty