New research out Friday should relieve anyone worried about having taken over-the-counter painkillers like ibuprofen before becoming sick with covid-19. The large study found no evidence that recent prior use of non-steroidal anti-inflammatory drugs (NSAIDs) led to more serious illness or death among hospitalised patients with covid-19.
Early on in the pandemic, some doctors raised concerns that NSAIDs should be avoided for covid-19 patients. In lab rats, NSAIDs like ibuprofen are known to raise levels of the protein angiotensin-converting enzyme 2 (ACE2), which is also used by the coronavirus to enter human cells. The fear was that NSAIDs, along with two other types of medications (ACE inhibitors and ACE2 receptor blockers), could potentially boost the virus’s ability to infect people and cause serious illness. There was also evidence at the time that people with diabetes and/or hypertension were more vulnerable to severe covid-19, possibly because they were more likely to take these drugs.
The link between severe covid-19 and these chronic conditions has become well-established at this point. But some, if not all, research has suggested that NSAIDs and these other drugs don’t have any real impact on covid-19 outcomes. To help finally settle the debate, researchers have published what they say is the largest study of its kind done so far. Their work appears in the journal Lancet Rheumatology.
The review’s authors analysed the hospital records of more than 70,000 patients in the UK who were hospitalised with covid-19. Of these patients, 4,211 were reported to have taken NSAIDs before admission. When compared to people without NSAID use, those who took them were just as likely to eventually die (about 30%) during or soon after their hospital visit. They also weren’t any more likely to need critical care or interventions like oxygen and ventilation. The same pattern held true when only looking at patients with inflammatory or immune-related disorders.
“When the pandemic began over a year ago, we needed to be sure that these common medications would not lead to worse outcomes in people with covid-19,” said lead study author Ewen Harrison, a researcher at the University of Edinburgh in the UK, in a statement released by the Lancet. “We now have clear evidence that NSAIDs are safe to use in patients with covid-19, which should provide reassurance to both clinicians and patients that they can continue to be used in the same way as before the pandemic began.”
The study’s conclusions should still be confirmed by more research, but most of the relevant data collected before and during the pandemic does seem to point to no effect from NSAIDs on covid-19. A review conducted by the World Health Organisation in April 2020, for instance, concluded that there was no evidence that NSAIDs had an effect on the health or survival of covid-19 patients.