Is Ibuprofen Guilty In Aiding COVID-19?

Jury is hung on ACE inhibitors and NSADs implications

Ibuprofen

Ibuprofen

On March 11, doctors at University Hospital in Switzerland and Aristotle University of Thessaloniki, in Greece, revealed ibuprofen was not safe to use for fever and inflammation accompanying infection with the coronavirus COVID-19. Their opinion was not peer-reviewed bur rather published as a letter in The Lancet Respiratory Medicine.

The doctors’ review of case reports for nearly 1,300 patients who were in the throes of Covid-19, found a high percentage of them suffered hypertension and blood sugar issues and used blood-pressure drugs called ACE inhibitors. These drugs inhibit or, perhaps, put more accurately, modulate and change the expression of the body’s family of angiotensin-converting enzymes (ACE). ACE inhibitors cause the body to emphasize expression of a particular protein called ACE2. It just so happens that COVID-19 likes to use the ACE2 proteins on the outer surfaces of lung cells’ membranes to attach to and begin their hijacking of the respiratory system.

ACE inhibitors are more commonly thought of as blood-pressure drugs. But ibuprofen, which is a non-steroidal anti-inflammatory drug (NSAID) used for inflammation, joint and muscle pain, and fever, also has an ACE-inhibiting effect and causes ACE2 expression.

GUILTY IN FRANCE

As it was, ibuprofen had already been under scrutiny by French health officials. In April 2019, the French Ministry of Health notified the public that NSAIDs, as a class, were suspected of exacerbating and worsening bacterial infections based on nearly 400 such cases between 2000 and 2018. People taking a lot of ibuprofen with antibiotics seemed to suffer from blood poisoning, brain inflammation, and skin infections, according to the report.

In January 2020, ibuprofen and paracetamol (acetaminophen) sales were restricted and required a pharmacy consultation before purchase.

The French Ministry of Health issued its own warning following the letter in The Lancet and offered up the possibility of “serious adverse events” that could occur among some COVID-19 patients.

Then Dr. Olivier Véran, the French minister of health, advised against ibuprofen use in a tweet as “an aggravating factor” in coronavirus infections. Instead, the physician recommended use of paracetamol, which is not an ACE inhibitor (but is toxic to the liver and kidneys when used at high, chronic doses).

Next reports came out in United States, United Kingdom, Israel, Singapore, and New Zealand. The French press identified COVID-19 victims, including a 28-year-old male, who had taken a lot of ibuprofen.

But authoritative organizations including the European Medicines Agency and World Health Organization opposed stopping use of ibuprofen. Simultaneously, one of the letter’s co-authors Dr. Michael Roth, was quoted in an update on the University of Basel’s website that, “It does not constitute a recommendation to use certain drugs or not.”

The bottom line is that medical science has no definitive answers at this time. It isn’t known if drugs up-regulating ACE2 expression are risk factors for COVID-19 infections or deaths. It might be better with all things being equal to use acetaminophen rather than ibuprofen with patients who have a COVID-19 diagnosis, say French health officials. Not all the world is ready to go that far.

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