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Clin Microbiol Infect ; 26(9): 1259.e5-1259.e7, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-597470


OBJECTIVE: It was recently suggested that ibuprofen might increase the risk for severe and fatal coronavirus disease 2019 (COVID-19) and should therefore be avoided in this patient population. We aimed to evaluate whether ibuprofen use in individuals with COVID-19 was associated with more severe disease, compared with individuals using paracetamol or no antipyretics. METHODS: In a retrospective cohort study of patients with COVID-19 from Shamir Medical Centre, Israel, we monitored any use of ibuprofen from a week before diagnosis of COVID-19 throughout the disease. Primary outcomes were mortality and the need for respiratory support, including oxygen administration and mechanical ventilation. RESULTS: The study included 403 confirmed cases of COVID-19, with a median age of 45 years. Of the entire cohort, 44 patients (11%) needed respiratory support and 12 (3%) died. One hundred and seventy-nine (44%) patients had fever, with 32% using paracetamol and 22% using ibuprofen, for symptom-relief. In the ibuprofen group, 3 (3.4%) patients died, whereas in the non-ibuprofen group, 9 (2.8%) patients died (p 0.95). Nine (10.3%) patients from the ibuprofen group needed respiratory support, compared with 35 (11%) from the non-ibuprofen group (p 1). When compared with exclusive paracetamol users, no differences were observed in mortality rates or the need for respiratory support among patients using ibuprofen. CONCLUSIONS: In this cohort of COVID-19 patients, ibuprofen use was not associated with worse clinical outcomes, compared with paracetamol or no antipyretic.

COVID-19/drug therapy , COVID-19/mortality , Fever/drug therapy , Ibuprofen/therapeutic use , Acetaminophen/adverse effects , Acetaminophen/therapeutic use , Adult , Antipyretics/adverse effects , Antipyretics/therapeutic use , Female , Fever/virology , Humans , Ibuprofen/adverse effects , Israel , Male , Middle Aged , Retrospective Studies
Am J Gastroenterol ; 115(8): 1153-1155, 2020 08.
Article in English | MEDLINE | ID: covidwho-525850

Coronavirus Infections/physiopathology , Digestive System Diseases/physiopathology , Pneumonia, Viral/physiopathology , Abdominal Pain/etiology , Abdominal Pain/metabolism , Abdominal Pain/physiopathology , Abdominal Pain/therapy , Ambulatory Care , Anorexia/etiology , Anorexia/metabolism , Anorexia/physiopathology , Anorexia/therapy , Anti-Bacterial Agents/adverse effects , Antipyretics/adverse effects , Antiviral Agents/adverse effects , Betacoronavirus , COVID-19 , Chemical and Drug Induced Liver Injury/etiology , Chemical and Drug Induced Liver Injury/metabolism , Chemical and Drug Induced Liver Injury/physiopathology , Chemical and Drug Induced Liver Injury/therapy , China , Clostridium Infections/diagnosis , Clostridium Infections/drug therapy , Coronavirus Infections/complications , Coronavirus Infections/metabolism , Coronavirus Infections/therapy , Diarrhea/etiology , Diarrhea/metabolism , Diarrhea/physiopathology , Diarrhea/therapy , Digestive System Diseases/etiology , Digestive System Diseases/metabolism , Digestive System Diseases/therapy , Endoscopy, Digestive System , Gastroenterology , Humans , Liver Diseases/etiology , Liver Diseases/metabolism , Liver Diseases/physiopathology , Liver Diseases/therapy , Nausea/etiology , Nausea/metabolism , Nausea/physiopathology , Nausea/therapy , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/metabolism , Pneumonia, Viral/therapy , Probiotics/therapeutic use , SARS-CoV-2 , Societies, Medical , Vomiting/etiology
Med Hypotheses ; 144: 109880, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-361316


Fever has been reported as a common symptom occurring in COVID-19 illness. Over the counter antipyretics such as ibuprofen and acetaminophen are often taken by individuals to reduce the discomfort of fever. Recently, the safety of ibuprofen in COVID-19 patients has been questioned due to anecdotal reports of worsening symptoms in previously healthy young adults. Studies show that ibuprofen demonstrates superior efficacy in fever reduction compared to acetaminophen. As fever may have benefit in shortening the duration of viral illness, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response when taken during the early stages of COVID-19 illness.

Antipyretics/adverse effects , Antipyretics/therapeutic use , COVID-19/drug therapy , Fever/drug therapy , Ibuprofen/adverse effects , Ibuprofen/therapeutic use , Acetaminophen/therapeutic use , Fever/physiopathology , Humans , Models, Theoretical , Patient Safety , Treatment Outcome