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The World Health Organization said last week that ibuprofen should be avoided when treating COVID-19 patients, but then tweeted a statement saying that "Based on currently available information, WHO does not recommend against the use of ibuprofen. We are also consulting with physicians treating COVID-19 patients and are not aware of reports of any negative effects of ibuprofen, beyond the usual known side effects that limit its use in certain populations."
The United Kingdom’s National Health Service echoed the WHO statement posting on its website that “There is currently no strong evidence that ibuprofen can make coronavirus (COVID-19) worse, and the organization recommended the use of paracetamol for COVID-19.
Dr. Anthony Fauci said in a Journal of the American Medical Association question and answer session that he had not seen data that showed ibuprofen was a concerning factor in treating the virus.
Dr. Jeffrey Klausner, professor of medicine and public health at the University of California Los Angeles Fielding School of Public Health, says that currently, “we know very little” about how using ibuprofen may impact a patient’s experience with COVID-19.
One potential connection is that in high doses of NSAIDs can damage the kidneys. COVID-19 can also affect kidney function. “We know that the coronavirus can cause sepsis in severely infected patients and sepsis can be associated with kidney problems,” Klausner says.
But the connection between coronavirus and ibuprofen may not be direct. “Unfortunately, with so many places experiencing patients with COVID-19, almost inevitably we’re going to see some strange associations, and it’s hard to know what’s going to be real and what’s noise,” says Dr. Larry William Chang, associate professor of medicine, epidemiology and international health at the Johns Hopkins Medicine in Baltimore.
According to the CDC, symptoms of COVID-19 typically appear two to 14 days after exposure and include:
- Cough.
- Fever.
- Shortness of breath.
Shrestha says that “80% of patients have mild symptoms,” and if you fall into this category, you should seek “supportive measures” that treat symptoms, such as using acetaminophen to reduce fever. He also recommends drinking plenty of water and eating soup to remain hydrated.
If you have a fever and body aches that may be associated with the coronavirus, Klausner also recommends treating these symptoms with acetaminophen because it’s “a very effective way to reduce fever,” he says.
Because this novel coronavirus is part of the family of viruses that cause the common cold, Klausner adds that “people with mild symptoms can manage this like the common cold with over the-counter cold medications.” The remedies you might use to feel better with a common cold to “reduce muscle aches, fevers, headaches would be appropriate,” he says.
[
SEE:
Flu vs. the Common Cold: Symptoms and Treatment. ]
Get Tailored Advice
For otherwise healthy adults with no complicating medical conditions, Chang agrees that acetaminophen might be the better option for treating pain and fever associated with the coronavirus until we know more.
However, he notes that there are some caveats to that recommendation. “Many critically ill patients with COVID-19 do experience significant complications with their kidneys and liver, so that can make choosing the right medication for their fever pretty complicated. So, for example, if you have any damage to your kidneys already, you typically do not want to use NSAIDs as that can make things a lot worse.”
But for folks with liver problems, the opposite might be true, Chang says. “If there’s something wrong with the liver, we generally tell people to avoid using acetaminophen because high doses of that it can harm the liver.”
The bottom line, Chang says, is to get advice that’s specific to you and your health situation. If you’ve been diagnosed with COVID-19, “talk with your healthcare provider about the overall medical situation. For example, if you’re elderly and have chronic kidney disease, then you probably do want to avoid ibuprofen. If you have cirrhosis of the liver for example, you might want to avoid acetaminophen. It needs to be tailored to each individual.”
If you’re currently under doctor’s orders to take ibuprofen regularly for another condition, ask your doctor for guidance.
Severe Cases of COVID-19
If your symptoms are severe, contact your health care provider for guidance on how best to proceed. Those with severe cases may end up hospitalized, at which point your doctor will run blood tests and conduct other examinations to further determine the best course of action, Chang says. The CDC reports that emergency warning signs for COVID-19 include:
- Difficulty breathing or shortness of breath.
- Persistent pain or pressure in the chest.
- New confusion or inability to arouse
- Bluish lips or face.
Other symptoms may also be present, so be sure to contact your health care provider for assistance if you develop any of the above symptoms. “Stay hydrated, and if symptoms get worse, seek medical attention – but please call (your) doctor first before visiting clinic/hospital to minimize risk of exposure to others,” Shrestha says.
If you’re hospitalized with severe illness, you may be given anti-malarial medications or other medications that are used in the treatment of HIV. “However, no specific medication has been approved yet” for the treatment of COVID-19, Shrestha says. Care typically centers around keeping the airways open and managing symptoms.
Because there is no cure or vaccine yet for COVID-19, prevention is your best strategy, Shrestha says. Wash your hands frequently. Limit contact with other who may have the virus and practice social distancing. Get vaccines against other illnesses such as the flu.
He adds that there is “no evidence to support the use of vitamin C, vitamin E or probiotic supplements.” He also notes that “antibiotics will not help unless you have bacterial infection, but co-infection seems quite rare.”