There has been a lot of confusion in recent weeks about how ibuprofen may increase risks for contracting the novel coronavirus or impact the severity of the illness resulting from COVID-19 infection. Questions began after the publication of a paper in The Lancet Respiratory Medicine that pointed to the possibility that ibuprofen can increase angiotensin-converting enzyme 2 (ACE2) – an enzyme that is used by COVID-19 to bind human cells together.

The opportunity for this comment arose because authors of the paper hypothesized that patients with diabetes and hypertension are at increased risk for severe forms of COVID-19 infection when they are taking drugs that stimulate ACE2. The researchers therefore speculated that the COVID-19 infection may be facilitated by higher levels of ACE2.

After the paper’s publication, the French government issued recommendations that acetaminophen be used rather than non-steroidal anti-inflammatory drugs (NSAIDs) in COVID-19 patients. The response to these recommendations were statements by scientists and eventually by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) that there is no evidence that ibuprofen or other NSAIDs enhance the severity of COVID-19 symptoms.

As previous data on the influence of ibuprofen on bacterial infections has suggested that ibuprofen may worsen these infections, researchers seem to agree that more research should be conducted to determine if ibuprofen may affect the experience of the COVID-19 virus. Nonetheless, for now, official recommendations seem to be that those with the virus who are taking ibuprofen do not need to terminate their medication but that, as always, all medication options should be discussed with your physician to treat symptoms in the safest way possible.

References

1. EMA. EMA gives advice on the use of non-steroidal anti-inflammatories for COVID-19. https://www.ema.europa.eu/en/news/ema-gives-advice-use-non-steroidal-anti-inflammatories-covid-19. Accessed April 6, 2020.
2. Fang L, et al. Lancet Respir Med. 2020;doi:10.1016/S2213-2600(20)30116-8.
3. FDA. FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19. https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19. Accessed April 6, 2020.