Coronavirus: Ibuprofen tested as a treatment

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Scientists are running a trial to see if ibuprofen can help hospital patients who are sick with coronavirus.

The team from London’s Guy’s and St Thomas’ hospital and King’s College believe the drug, which is an anti-inflammatory as well as a painkiller, could treat breathing difficulties.

They hope the low-cost treatment can keep patients off ventilators.

In the trial, called Liberate, half of the patients will receive ibuprofen in addition to usual care.

The trial will use a special formulation of ibuprofen rather than the regular tablets that people might usually buy. Some people already take this lipid capsule form of the drug for conditions like arthritis.

Studies in animals suggest it might treat acute respiratory distress syndrome – one of the complications of severe coronavirus.

Prof Mitul Mehta, one of the team at King’s College London, said: “We need to do a trial to show that the evidence actually matches what we expect to happen.”

Early in the pandemic, there were some concerns that ibuprofen might be bad for people to take, should they have the virus with mild symptoms.

These were heightened when France’s health minister Oliver Veran said that taking non-steroidal anti-inflammatory drugs, such as ibuprofen, could aggravate the infection and advised patients to take paracetamol instead.

A review by the Commission on Human Medicines quickly concluded that, like paracetamol, it was safe to take for coronavirus symptoms. Both can bring a temperature down and help with flu-like symptoms.

For mild coronavirus symptoms, the NHS advises people to try paracetamol first, as it has fewer side-effects than ibuprofen and is the safer choice for most people. You should not take ibuprofen if you have a stomach ulcer, for example.

Coronavirus and ibuprofen: Separating fact from fiction

A woman holds a painkiller pill and a glass of water

Stories have been circulating online suggesting it’s dangerous to take ibuprofen if you have coronavirus. Alongside genuine medical advice, false messages have been spreading, distorting the facts.

Speaking to the BBC, medical professionals said that ibuprofen is not recommended for managing coronavirus symptoms.

The NHS says that, while “there is currently no strong evidence that ibuprofen can make coronavirus (Covid-19) worse 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.”

Those already taking ibuprofen for other conditions should not stop without consulting a doctor, though.

Both paracetamol and ibuprofen can bring a temperature down and help with flu-like symptoms. But ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) are not suitable for everyone and can cause side-effects – especially for people with asthma, heart, and circulatory problems.

The NHS website previously recommended both paracetamol and ibuprofen but has since changed its advice.

There is also some evidence linking ibuprofen to more severe illnesses from other respiratory infections.

False stories

But whatever the advice, there’s still been a great deal of misinformation online. Bogus messages have been circulating on WhatsApp claiming that:

• “There are four young people in an intensive care unit in Cork who have no underlying illnesses – all were taking anti-inflammatories and there are concerns this has caused a more severe illness” (false)

• The University of Vienna has sent a memo warning people with coronavirus symptoms not to take ibuprofen, “because it has been discovered that it increases the speed of reproduction of the coronavirus Covid-19 in the body and this is the reason why people in Italy have reached the current bad stage and rapid spread” (false)

• “At the university hospital in Toulouse, France, there are four very critical cases of coronavirus in [young people] who do not have any health problems. Their problem is that when they all appeared to have symptoms, they all took painkillers like ibuprofen” (false)

These stories circulating on WhatsApp are also appearing on different platforms including Instagram.

Commonly these kinds of copied-and-pasted texts will claim to be from someone the forwarder says they know, often with a medical background.

All these claims are false

The Infectious Diseases Society of Ireland said a WhatsApp message circulating about coronavirus patients in Cork is “a fake message”, asking anyone who receives it to “ignore and delete”.

Toulouse University Hospital warned that inaccurate information was circulating on social networks, saying it would not have discussed the care of patients due to medical confidentiality.

So what do we know about ibuprofen and Covid-19?
There has been no research into ibuprofen and the new coronavirus (Covid-19).

But there have been some for other respiratory infections, suggesting ibuprofen is linked to more complications and more severe illness, according to Paul Little, a professor of primary care research at the University of Southampton.

Experts believe that ibuprofen’s anti-inflammatory properties may “dampen” the body’s immune response.

Prof Parastou Donyai at the University of Reading says: “There are many studies that suggest ibuprofen use during a respiratory infection can result in worsening of the disease or other complications.”

But, she says, “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.”

Although we don’t yet know whether ibuprofen has a particular effect on the severity or length of illnesses caused by coronavirus – either in healthy people or those with underlying conditions – Dr. Charlotte Warren-Gash, of the London School of Hygiene and Tropical Medicine, says, especially for vulnerable patients, “it seems sensible to stick to paracetamol as the first choice”.

Empty paracetamol shelves

The spreading of rumors has led to confusion

Worries over the use of ibuprofen appear to have surfaced in France, after Jean-Louis Montastruc, a doctor at Toulouse University Hospital warned on Twitter that: “In this period of coronavirus, it is necessary to remember the risk of complications of the NSAIDs in case of fever or infection.”

A subsequent tweet by France’s health minister, Olivier Veran, saying that anti-inflammatory drugs “could be an aggravating factor of the infection” was shared more than 43,000 times. But he also said people should consult a doctor before stopping taking them.

Other tweets are also being shared including one saying that ibuprofen “may cause severe cases of the disease, even in young and middle-aged adults with no underlying conditions” which has been shared more than 94,000 times on Twitter.

Screengrab from Facebook of a viral message about coronavirus and ibuprofen
Image captionMany people on social media appeared to have “a doctor in the family” with inside information

A lack of clear consensus on the issue from the medical profession has led to mixed messages and rumors spreading online, and the University of Vienna laboratory claim noted earlier seems to have taken on a life of its own in both English and German.

Twitter and Facebook posts – which seem to be cut-and-pasted and adapted by users – all claim to have a “doctor in the family” who has information from the Vienna lab that “the vast majority of people who died of Covid-19 had ibuprofen in their system”. Some of the posts go on to claim that coronavirus “thrives on ibuprofen”. There is no evidence that this is the case.

This online rumor also appeared on German-language WhatsApp as voice messages and text messages. These messages typically claimed to be from a young mother saying that the Vienna lab had researched Covid-19 deaths in Italy and found that the majority had self-medicated with ibuprofen. The message offers no specific evidence to back up its claims, according to the German pharmaceutical news website aponet.de. “Such a pattern is typical of conspiracy theories,” it concludes.

Source: bbc.com

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