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 limited clinical data currently, especially with regard to acute usage at onset of infection. The only RCT compares with acetaminophen.
Ibuprofen has been officially adopted
in 4 countries.
Submit updates/corrections .
Sep 24 |
Ibuprofen for COVID-19: real-time meta analysis of 13 studies | |
| Meta analysis using the most serious outcome reported shows 0% [-9‑9%] lower risk, without reaching statistical significance. • 4 studies from 4 independent teams in 4 countries show statistically significant improvements. • .. | ||
Apr 19 |
et al., The Open Anesthesia Journal, doi:10.2174/25896458-v17-e230403-2022-26 | Early Use of Ibuprofen in Moderate Cases of COVID-19 Might be a Promising Agent to Attenuate the Severity of Disease: A Randomized Controlled Trial |
| 52% lower ICU admission (p=0.05), 52% lower need for oxygen therapy (p=0.05), and 26% shorter hospitalization (p=0.01). RCT 180 moderate hospitalized COVID-19 patients in Egypt, showing lower ICU admission and shorter hospitalization with ibuprofen compared with acetaminophen. | ||
Aug 16 2022 |
et al., medRxiv, doi:10.1101/2022.08.14.22278751 | 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 2022 |
et al., Drugs, doi:10.1007/s40265-022-01822-z (date from preprint) | 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 2022 |
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 2021 |
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 2021 |
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 2021 |
et al., medRxiv, doi:10.1101/2021.04.13.21255438 | 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 2021 |
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 2020 |
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 2020 |
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 2020 |
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 2020 |
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 2020 |
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 2020 |
, M., BMJ, doi:10.1136/bmj.m1086 | Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists |
| Discussion of potential harms of ibuprofen use for COVID-19. | ||
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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
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physician who can provide personalized advice and details of risks and
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