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Acetaminophen COVID-19 studies. Concerns have been raised over the use of acetminophen for COVID-19 [Pandolfi, Sestili]. While there is limited clinical data, with the only RCT comparing with indomethacin, studies to date suggest the potential for harm. Recent:
Abolhassani
Kolin
Jeong
Reese
Oh
Xie
MacFadden.
Acetaminophen has been officially adopted for early treatment in 3 countries. Submit updates/corrections.
Oct 4
Covid Analysis (Preprint) (meta analysis) Acetaminophen for COVID-19: real-time meta analysis of 15 studies
Meta analysis using the most serious outcome reported shows 30% [11‑53%] higher risk. • Concerns have been raised over the use of acetminophen for COVID-19 [Pandolfi, Sestili]. While there is limited clinical data, with the o..
Sep 13
Abolhassani et al., Journal of Allergy and Clinical Immunology, doi:10.1016/j.jaci.2022.09.005 Genetic and immunological evaluation of children with inborn errors of immunity and severe or critical COVID-19
56% higher mortality [p=0.64]. Retrospective 31 hospitalized patients ≤19 with pre-existing inborn errors of immunity, showing no significant difference in mortality with acetaminophen use.
Jul 30
Lapi et al., Internal and Emergency Medicine, doi:10.1007/s11739-022-03054-1 To clarify the safety profile of paracetamol for home-care patients with COVID-19: a real-world cohort study, with nested case–control analysis, in primary care
15% higher combined mortality/hospitalization [p=0.22]. Retrospective paracetamol use with a primary care database in Italy, showing no significant difference in hospitalization/death for use 0-3 and 4-7 days from diagnosis, and significantly higher risk for use >7 days from diagnosis. Confou..
Jul 13
Xie et al., SSRN Electronic Journal, doi:10.2139/ssrn.4161710 Risk of COVID-19 Diagnosis and Hospitalization in Patients with Osteoarthritis or Back Pain Treated with Ibuprofen Compared to Other NSAIDs or Paracetamol: A Network Cohort Study
5% higher hospitalization [p=0.83] and 3% fewer cases [p=0.82]. PSM retrospective 1,370,600 osteoarthritis or back pain patients in the US, showing no significant differences in COVID-19 cases and hospitalization for paracetamol vs. ibuprofen.
May 5
Campbell et al., PLOS ONE, doi:10.1371/journal.pone.0267462 Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen and relationship with mortality among United States Veterans after testing positive for COVID-19
1% higher mortality [p=0.43]. Retrospective 28,856 COVID-19 patients in the USA, showing no significant difference in mortality for chronic acetaminophen use vs. sporadic NSAID use. Since acetaminophen is available OTC and authors only tracked prescriptions, many pati..
Apr 19
Ravichandran et al., Scientific Reports, doi:10.1038/s41598-022-10370-1 An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
43% worse recovery [p=0.002], 3925% higher progression [p<0.0001], and 20% worse viral clearance [p=0.19]. RCT with 107 paracetamol and 103 indomethacin patients, showing higher progression and worse recovery with paracetamol.
Mar 30
Lerner et al., JMIR Medical Informatics, doi:10.2196/35190 Mining Electronic Health Records for Drugs Associated With 28-day Mortality in COVID-19: Pharmacopoeia-wide Association Study (PharmWAS)
31% higher mortality [p=0.1]. Retrospective 5,783 hospitalized patients in France, showing higher mortality with paracetamol use, without statistical significance.
Mar 29
MacFadden et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156 Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications
48% more cases [p<0.0001]. Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing higher cases with chronic use of acetaminophen.
Dec 2
2021
Pandolfi et al., Basic & Clinical Pharmacology & Toxicology, doi:10.1111/bcpt.13690 (Review) Home pharmacological therapy in early COVID‐19 to prevent hospitalization and reduce mortality: Time for a suitable proposal
Proposal for early treatment of COVID-19, including a review of potential concerns for treatment with acetaminophen and a recommendation against using acetaminophen.
Oct 31
2021
Manjani et al., Chest, doi:10.1016/j.chest.2021.07.992 Effects of acetaminophen on outcomes in patients hospitalized with COVID-19
224% higher mortality [p=0.001], 434% higher ventilation [p=0.001], 244% higher progression [p=0.005], and 100% longer hospitalization [p=0.001]. Retrospective 524 hospitalized patients in the USA, showing higher mortality and progression with acetaminophen use.
Aug 16
2021
Leal et al., COVID, doi:10.3390/covid1010018 Paracetamol Is Associated with a Lower Risk of COVID-19 Infection and Decreased ACE2 Protein Expression: A Retrospective Analysis
7% fewer cases [p=0.004]. UK Biobank retrospective showing lower cases with acetaminophen use.
Jun 25
2021
Pandolfi et al., Journal of Medical Virology, doi:10.1002/jmv.27158 (Review) Paracetamol in the home treatment of early COVID‐19 symptoms: A possible foe rather than a friend for elderly patients?
Review of potential concerns for treatment of COVID-19 with acetaminophen.
Jun 24
2021
Oh et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18136804 Musculoskeletal Disorders, Pain Medication, and in-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study
2% lower mortality [p=0.97]. Retrospective 7,713 COVID-19 patients in Korea, showing no significant difference in mortality with paracetamol use.
Apr 29
2021
Chandan et al., Arthritis & Rheumatology, doi:10.1002/art.41593 Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID‐19
18% higher mortality [p=0.35] and 27% more cases [p=0.17]. Retrospective 12,457 patients prescribed paracetamol with codeine/dihydrocodeine and 13,202 prescribed NSAIDs, showing no significant differences in cases and mortality. Patients prescribed codeine/dihydrocodeine may have different suscep..
Apr 20
2021
Reese et al., medRxiv, doi:10.1101/2021.04.13.21255438 (Preprint) Cyclooxygenase inhibitor use is associated with increased COVID-19 severity
61% higher mortality [p<0.0001] and 816% higher severe cases [p<0.0001]. N3C retrospective 250,533 patients showing significantly higher mortality with acetaminophen use. Note that acetaminophen results were not included in the journal version or v2 of this preprint.
Mar 3
2021
Park et al., Scientific Reports, doi:10.1038/s41598-021-84539-5 Non-steroidal anti-inflammatory agent use may not be associated with mortality of coronavirus disease 19
25% lower mortality [p=0.46] and 38% lower ventilation [p=0.42]. Retrospective 2,365 patients prescribed acetaminophen and 398 prescribed NSAIDs in South Korea, showing
Nov 17
2020
Kolin et al., PLOS ONE, doi:10.1371/journal.pone.0241264 Clinical, regional, and genetic characteristics of Covid-19 patients from UK Biobank
23% more cases [p=0.009]. 397,064 patient UK Biobank retrospective showing higher risk of COVID-19 with acetaminophen use.
Oct 7
2020
Sestili et al., Frontiers in Pharmacology, doi:10.3389/fphar.2020.579944 (Review) Paracetamol-Induced Glutathione Consumption: Is There a Link With Severe COVID-19 Illness?
Discussion of the potential negative effects of acetaminophen for COVID-19 based on promotion of glutathione depletion, especially in population groups at higher risk
Sep 30
2020
Rinott et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.06.003 Ibuprofen use and clinical outcomes in COVID-19 patients
473% higher mortality [p=0.3] and 534% higher need for oxygen therapy [p=0.06]. Retrospective 89 febrile COVID-19 patients in Israel taking paracetamol and 49 taking ibuprofen, showing higher need for respiratory support with paracetamol.
Jul 27
2020
Jeong et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa1056 Association Between Nonsteroidal Antiinflammatory Drug Use and Adverse Clinical Outcomes Among Adults Hospitalized With Coronavirus 2019 in South Korea: A Nationwide Study
Retrospective 1,824 hospitalized COVID-19 patients in South Korea, showing higher progression to combined death, ICU, ventilation, or sepsis (4% versus 0%, group sizes not provided) with paracetamol vs. NSAIDs. Treatment time may vary - e..
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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