Getty Packets of chloroquine.
There is a lot of information out there about the COVID-19 coronavirus pandemic. Every day, new updates are released about the number of cases, testing information and the projection of the virus. With all of this information, there is a risk of misinformation spreading. There is also a lot that is not yet known about this new coronavirus.
One question that has been asked a lot in the last couple of days is whether people should take ibuprofen or paracetamol for coronavirus symptoms. There have been a lot of stories circulating online saying that it can be dangerous to take ibuprofen if you have tested positive for coronavirus.
Studies Show That Treating Fever May Actually Prolong or Worsen the Illness & People Should Avoid Taking Any Medication to Treat Fever
March 16, 2020 in the southern Israeli city of Ashdod.
Heavy spoke to Dr. Paul Offit, the Director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia.
Dr. Offit said he doesn’t believe paracetamol should be recommended over ibuprofen. Instead, “the better recommendation would be to say don’t use either.”
Offit highlighted that fever is actually a desirable symptom and that humans make fever for a reason. He said the reason we do this is because “fever increases our immune response, pretty much across the board.” He continued, explaining that “Your immune response works better at a higher temperature.”
He also pointed out that many studies have shown that taking antipyretics (fever-reducing medicines) will actually “prolong and worsen the illness.”
One of these studies, which compared different antipyretic medications, found that “a trend toward longer duration of virus shedding was observed in the aspirin and acetaminophen [paracetamol] groups.” It also found that “Use of aspirin and acetaminophen [paracetamol] was associated with suppression of serum neutralizing antibody response and increased nasal symptoms and signs.”
Another study was completed that compared societies that treated the fever to societies that didn’t, and it found that societies that treated fever led to a lot more people leaving their homes because they felt better, even though they were still shedding the virus. As Dr. Offit explained, this led to a “far greater amount of disease, hospitalization, and frankly death.”
There Is Not Enough Data on the Use of Anti-Inflammatory Drugs in Patients With COVID-19
An undated handout photo from the Centers for Disease Control and Prevention (CDC).
Dr. Alan Koff, Chief Fellow of the Infectious Disease Program at the Yale School of Medicine in New Haven, Conn. told Heavy in a statement that “Currently, it is unclear if [nonsteroidal anti-inflammatory drugs] (NSAIDs) should be avoided in COVID-19 infection.”
He continued, “We do not have good epidemiological data right now, so patients who have been diagnosed with COVID-19 should follow the advice of their medical providers. Whether NSAIDs are helpful or harmful in COVID-19 infection will only become clear after reviewing larger patient data sets.”
Dr. Koff also mentioned that cases may vary with patients who have pre-existing health conditions:
It’s important to note that many patients on NSAIDs have pre-existing health conditions such as autoimmune disease, and these may be the patients who are more susceptible to complications of COVID-19 infection, regardless of the fact that they may be prescribed NSAIDs.
In some cases, health providers may recommend stopping NSAIDs because of the risk of peptic ulcers and kidney injury that can occur, especially if the body is under stress for other reasons, but not because of fear of worsening the infection. Others may minimize the use of NSAIDs in patients with COVID-19 infection. Acetaminophen can be used in its place, and is considered safe when taken at recommended doses.
There Is No Clear Consensus Online About Taking Paracetamol Over Ibuprofen
The National Health Service in the United Kingdom wrote on its website that “There is currently no strong evidence that ibuprofen can make coronavirus (COVID-19) worse.” However, they did add that “until we have more information, take paracetamol to treat the symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you.”
On the other hand, in the United States, the CDC says that there are a few options to lower your temperature: acetaminophen (paracetamol), ibuprofen and aspirin. It does not distinguish between these options or recommend taking paracetamol over ibuprofen.
The BBC reported that medical professionals speaking to the BBC “said that ibuprofen is not recommended for managing coronavirus symptoms.” They explained that “Both paracetamol and ibuprofen can bring a temperature down and help with flu-like symptoms, but ibuprofen and other non-steroidal anti-inflammatory drugs are not suitable for everyone and can cause side-effects – especially for people with asthma, heart and circulatory problems.”
The French health minister, Olivier Véran, tweeted a warning about ibuprofen that has been retweeted over 40,000 times. He said: “taking anti-inflammatories (ibuprofen, cortisone) could be an aggravating factor of the infection. If you have a fever, take paracetamol. If you are already taking anti-inflammatories or you are in doubt, consult with your doctor.”
Both the Toulouse University Hospital in France and the Infectious Diseases Society of Ireland have had to post online about fake information circulating. There have apparently been WhatsApp messages going around about both of these areas, saying that there are patients in critical condition after taking anti-inflammatories for their symptoms.
It has come to our attention that there is a WhatsApp message being circulated purporting to be from the ID consultants in Cork, all of whom are members of @IDSIreland. It’s signed Dr Tim. This is a fake message, please ignore and delete. Thanks.
Although the Toulouse University Hospital confirmed that these messages were inaccurate and that they would never discuss specific patients, they did tell people to be careful when using anti-inflammatories for fever and infection, as they can increase the risk of complications.
Because studies have shown that taking any kind of medicine for reducing fever can have adverse effects on the length of the illness and symptoms, it may be better to avoid both paracetamol and ibuprofen. However, as the CDC mentions, the best option is to speak to your healthcare provider for medical advice.
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