Ibuprofen and Coronovirus: What does literature suggest?
Since the coronavirus outbreak has begun, various conflicting information is circulating about the effect of ibuprofen on coronavirus patients. Some sources argue that ibuprofen will worsen the viral infection while others take a neutral stance or even argue that ibuprofen might help mitigate the damage of excessive inflammation on lungs.
To help better understand whether ibuprofen has a negative effect on patients with coronavirus, we need to look into dozens of high-quality studies performed by scientists on the subject matter and published in trustworthy scientific journals. I investigated different research databases to find such articles and I came across a systematic review that investigated 58 studies, and a single article that studied patients with diabetes and hypertension. Before I summarize findings from these studies, I would like to briefly talk about what inflammation is and the what ibuprofen does in our cells.
When a virus infects a cell, our body produces a balance of inflammatory and anti-inflammatory molecules to fight the virus. Inflammation is a normal bodily response to harmful stimuli. Inflammation helps with removing harmful stimuli such as viruses from cells and therefore is one of the defense mechanisms in our body. Ibuprofen inhibits the action of a cellular machine (enzyme) that produces inflammatory mediators. Therefore, it is proposed that if you take ibuprofen and you have inflammation that is trying hard to fight the virus, you are suppressing the inflammation by turning off the cellular machine that produces inflammatory mediators. However, inside living human cells things are not this simple at all. Immune response is very complex, and it involves the balance between inflammation and anti-inflammation. Too much inflammation can lead to organ damage. Too little inflammation and you have suppressed immune response to the fight the virus.
The news about effect of ibuprofen on coronavirus patients started when a study was published in a prestigious scientific journal, Lancet (see reference below). The study proposed that taking ibuprofen increases the expression of ACE2 inhibitors (channels in cells that allow coronavirus to enter the epithelial cells). Therefore, the authors hypothesized that by taking ibuprofen we are helping more of the virus get into the cells. However, keep in mind, this is a hypothesis based on studies done in lab animals. We do not have clinical studies done in humans to either confirm or refute these findings. More research is needed to figure out the effect of ibuprofen on living cells to make any conclusions.
Furthermore, the authors of a moderate quality systematic review that included 13 studies did not find evidence to suggest ibuprofen worsens symptoms of coronavirus. They also did not find evidence to suggest that ibuprofen makes the symptoms any better. Evidence at present is not conclusive, as there are not enough high-quality studies done on the topic to make a firm scientific conclusion.
Neumann,
MscPT, BSc Biomedical Sciences, Min. Pysch.
