Ibuprofen use and clinical outcomes in COVID-19 patients

Clin Microbiol Infect. 2020 Sep;26(9):1259.e5-1259.e7. doi: 10.1016/j.cmi.2020.06.003. Epub 2020 Jun 12.

Abstract

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.

Keywords: Antipyretics; Coronavirus disease 2019; Disease severity; Ibuprofen; Paracetamol.

MeSH terms

  • Acetaminophen / adverse effects
  • Acetaminophen / therapeutic use
  • Adult
  • Antipyretics / adverse effects
  • Antipyretics / therapeutic use
  • COVID-19 / drug therapy*
  • COVID-19 / mortality*
  • Female
  • Fever / drug therapy*
  • Fever / virology
  • Humans
  • Ibuprofen / adverse effects
  • Ibuprofen / therapeutic use*
  • Israel
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Antipyretics
  • Acetaminophen
  • Ibuprofen