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Ibuprofen for COVID-19
13 studies from 136 scientists
54,707 patients in 9 countries
Symptomatic results show 0% [-14-17%] higher risk.
COVID-19 Ibuprofen studies. Apr 2024.
0 0.5 1 1.5+ All studies 0% With exclusions 0% Mortality -2% Hospitalization 4% Cases -1% RCTs 52% Symptomatic -0% Prophylaxis -1% Early -52% Late 52% Favorsibuprofen Favorscontrol
Concerns have been raised over potential harm with the use of ibuprofen for COVID-19 Day due to the suppression of beneficial immune and inflammatory responses during early infection, ACE2 upregulation, and delaying further care. There is limited clinical data currently, especially with regard to acute usage at onset of infection, however current results suggest harm with early treatment and benefit with late treatment. Recent:
Ibuprofen has been officially adopted in 5 countries. Submit updates/corrections.
Apr 22
Covid Analysis 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. Concer..
Feb 2
Moshawih et al., Heliyon, doi:10.1016/j.heliyon.2024.e25734 Evaluating NSAIDs in SARS-CoV-2: Immunomodulatory mechanisms and future therapeutic strategies
Review of NSAIDs and their complex immunomodulatory roles in SARS-CoV-2 infection. Authors discuss the mechanisms by which NSAIDs impact viral replication, immune responses, and inflammation. They note NSAIDs can reduce neutrophil recruit..
Jan 3
Stuart et al., BMJ Open, doi:10.1136/bmjopen-2023-077365 NSAID prescribing and adverse outcomes in common infections: a population-based cohort study
219% higher combined mortality/hospitalization (p<0.0001). Retrospective 142,925 outpatients in the UK showing significantly higher risk of hospitalization or death with prescription of NSAIDs for respiratory tract infections (RTI) or urinary tract infections (UTI). Practice-level analysis also f..
Oct 18
Marjaneh et al., Journal of Infection, doi:10.1016/j.jinf.2023.10.009 Analysis of blood and nasal epithelial transcriptomes to identify mechanisms associated with control of SARS-CoV-2 viral load in the upper respiratory tract
Blood and nasal epithelial transcriptomic analysis suggesting potential benefits of several treatments including: Vitamin E: transcriptomic analysis revealed that the AIPL1 module, which contains genes connected to vitamin E (α-tocopherol..
May 16
Zurita-Lizza et al., Clinical and Translational Discovery, doi:10.1002/ctd2.204 Repurposing Inhaled Ibuprofenate, a Non Steroidal Anti‐Inflammatory Drug, as a Potential Adjuvant Treatment for Pneumonia, CARDS and its Aetiological Agent SARS‐CoV‐2
Review of the potential mechanisms of action and therapeutic effects of inhaled sodium ibuprofenate for the treatment of COVID-19 pneumonia. Authors describe potential anti-inflammatory, immunomodulatory, antiangiogenic, and virucidal eff..
Apr 19
Sobhy 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.
Dec 31
Kalayan et al., European Journal of Respiratory Medicine, doi:10.31488/EJRM.132 Safety and Efficacy of Nebulised Anti-Inflammatory Solution of Alkaline Hypertonic Ibuprofen (AHI) for Treatment of SARS-Cov-2 Infection: A Compassionate Study with a Comparator Arms
79% lower mortality (p=0.0009). Retrospective 99 COVID-19 patients in Argentina showing significantly lower mortality with inhaled alkaline hypertonic ibuprofen (AHI) treatment. The treatment has a pH of 8.5. 3 times daily for 7-10 days.
Aug 16
Loucera et al., Virology Journal, doi:10.1186/s12985-023-02195-9 (date from preprint) Real-world evidence with a retrospective cohort of 15,968 COVID-19 hospitalized patients suggests 21 new effective treatments
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, azithromycin, aspirin, vitamin D, vitamin C, and budesonide. Since only hospitalized ..
Jul 13
Xie 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 31
Calonico et al., National Bureau of Economic Research, doi:10.3386/w30084 Causal Inference During a Pandemic: Evidence on the Effectiveness of Nebulized Ibuprofen as an Unproven Treatment for COVID-19 in Argentina
49% lower mortality (p=0.01). Retrospective 5,146 hospitalized COVID-19 patients in Argentina, showing lower mortality associated with nebulized ibuprofen (NaIHS) treatment. Doubly robust inverse probability weighting estimators were used to control for confounding. A..
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 30
Salva et al., Infectious Diseases and Therapy, doi:10.1007/s40121-021-00527-2 Reversal of SARS-CoV2-Induced Hypoxia by Nebulized Sodium Ibuprofenate in a Compassionate Use Program
45% lower mortality (p=0.009) and 14% shorter hospitalization (p<0.0001). Retrospective 383 hospitalized COVID-19 patients in Argentina showing signifcantly lower mortality and shorter hospital stay with nebulized sodium ibuprofenate compared to 195 contemporaneous controls. The treatment appears to be the same..
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 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 23
Wrotek et al., Evolution, Medicine, and Public Health, doi:10.1093/emph/eoaa044 Let fever do its job
Review of fever focusing on COVID-19. Authors note that fever is a key component of the acute phase response to infection. Fever enhances immune cell performance, induces cellular stress on pathogens, and acts synergistically with other s..
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 Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists
Discussion of potential harms of ibuprofen use for COVID-19.
Dec 1
Graham et al., Journal of Infectious Diseases, doi:10.1093/infdis/162.6.1277 Adverse Effects of Aspirin, Acetaminophen, and Ibuprofen on Immune Function, Viral Shedding, and Clinical Status in Rhinovirus-Infected Volunteers
RCT examining the effects of aspirin, acetaminophen, and ibuprofen on immune function, virus shedding, and clinical symptoms in 60 healthy volunteers experimentally infected with rhinovirus type 2. The study found that aspirin and acetami..
Apr 30
Downing et al., Journal of Interferon Research, doi:10.1089/jir.1988.8.143 Hyperthermia in Humans Enhances Interferon-γ Synthesis and Alters the Peripheral Lymphocyte Population
Analysis of induced hyperthermia (high body temperature) showing 10 times greater interferon gamma (IFN-γ) production and increased natural killer cells. This response was observed at a core body temperature of ~39°C, highlighting its pot..
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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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