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Other Treatments Global Adoption
Ibuprofen COVID-19 studies. Concerns have been raised over potential harm from the use of ibuprofen for COVID-19 [Day], due to ACE2 upregulation; disrupting normal and beneficial action of the immune system; and delayed diagnosis. There is very limited clinical data currently, especially with regard to acute usage at onset of inefection, and there are no RCTs. Current studies do not show a significant difference in outcomes. Recent:
Ibuprofen has been officially adopted for early treatment in 3 countries. Submit updates/corrections.
Oct 4
Covid Analysis (Preprint) (meta analysis) Ibuprofen for COVID-19: real-time meta analysis of 12 studies
Meta analysis using the most serious outcome reported shows 1% [-8‑10%] higher risk, without reaching statistical significance. • Concerns have been raised over potential harm from the use of ibuprofen for COVID-19 [Day], due..
Aug 16
Loucera et al., medRxiv, doi:10.1101/2022.08.14.22278751 (Preprint) Real-world evidence with a retrospective cohort of 15,968 Andalusian COVID-19 hospitalized patients suggests 21 new effective treatments and one drug that increases death risk
48% lower mortality [p=0.002]. Retrospective 15,968 COVID-19 hospitalized patients in Spain, showing lower mortality with existing use of several medications including metformin, HCQ, aspirin, vitamin D, vitamin C, and budesonide.
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
12% higher hospitalization [p=0.26] and 8% more cases [p=0.25]. PSM retrospective 1,697,522 osteoarthritis or back pain patients in the US, showing no significant differences in COVID-19 cases and hospitalization for ibuprofen vs. other NSAIDs.
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
no change in mortality [p=0.54]. Retrospective 28,856 COVID-19 patients in the USA, showing no significant difference in mortality for chronic ibuprofen use vs. sporadic NSAID use. Since ibuprofen is available OTC and authors only tracked prescriptions, many patients cla..
Aug 16
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
3% fewer cases [p=0.29]. UK Biobank retrospective showing no significant difference in cases with ibuprofen use.
Jul 31
Drake et al., The Lancet Rheumatology, doi:10.1016/S2665-9913(21)00104-1 Non-steroidal anti-inflammatory drug use and outcomes of COVID-19 in the ISARIC Clinical Characterisation Protocol UK cohort: a matched, prospective cohort study
10% lower mortality [p=0.36]. Prospective study of 78,674 COVID-19 patients, showing no significant difference in mortality with ibuprofen use.
Apr 20
Reese et al., medRxiv, doi:10.1101/2021.04.13.21255438 (Preprint) Cyclooxygenase inhibitor use is associated with increased COVID-19 severity
9% lower mortality [p=0.65] and 303% higher severe cases [p<0.0001]. N3C retrospective 250,533 patients showing higher COVID-19 severity with ibuprofen use. Note that results for individual treatments are not included in the journal version or v2 of this preprint.
Jan 21
Wong et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-219517 Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts
23% higher mortality [p=0.19]. Retrospective 2,463,707 people in the UK, showing no significant difference in COVID-19 mortality with NSAID use. Current NSAID users were defined as those ever prescribed an NSAID in the 4 months prior to study start, and non-users were ..
Nov 2
Abu Esba et al., Infectious Diseases and Therapy, doi:10.1007/s40121-020-00363-w Ibuprofen and NSAID Use in COVID-19 Infected Patients Is Not Associated with Worse Outcomes: A Prospective Cohort Study
170% higher mortality [p=0.35], 45% higher need for oxygen therapy [p=0.64], 18% higher hospitalization [p=0.64], and 85% higher severe cases [p=0.42]. Prospective study of 503 COVID-19 cases in Saudi Arabia, 40 using ibuprofen during infection, and 357 not using NSAIDs, showing no significant differences in outcomes. Results are subject to confounding by indication.
Oct 21
Kragholm et al., Clinical and Translational Science, doi:10.1111/cts.12904 Association Between Prescribed Ibuprofen and Severe COVID‐19 Infection: A Nationwide Register‐Based Cohort Study
4% lower progression [p=0.78]. Retrospective 4,002 COVID-19 patients in Denmark, 264 with ibuprofen prescriptions, showing no significant difference for COVID-19 severity.
Sep 30
Rinott et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.06.003 Ibuprofen use and clinical outcomes in COVID-19 patients
21% higher mortality [p=0.73], 12% higher ventilation [p=0.77], and 40% higher ICU admission [p=0.56]. Retrospective 403 COVID-19 cases in Israel, showing no significant difference in outcomes with ibuprofen use. Patients were asked about ibuprofen use starting a week before diagnosis of COVID-19 - treatment time may have been early, late,..
Jul 13
Samimagham et al., Archives of Clinical Infectious Diseases, doi:10.5812/archcid.106847 The Association of Non-Steroidal Anti-Inflammatory Drugs with COVID-19 Severity and Mortality
100% higher mortality [p=0.001], 428% higher severe cases [p=0.0007], and 13% higher progression [p=0.04]. Retrospective 158 COVID-19 patients in Iran, showing higher risk of mortality with ibuprofen use.
Jun 23
Choi et al., Journal of Clinical Medicine, doi:10.3390/jcm9061959 Clinical Characteristics and Disease Progression in Early-Stage COVID-19 Patients in South Korea
240% higher progression [p=0.26]. Retrospective 293 patients in South Korea, showing higher risk of progression with ibuprofen use, without statistical significance.
Mar 17
Day, M., BMJ, doi:10.1136/bmj.m1086 (Review) Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists
Discussion of potential harms of ibuprofen use for COVID-19.
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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Thanks for your feedback! Please search before submitting papers and note that studies are listed under the date they were first available, which may be the date of an earlier preprint.