Abstract: Clinical Microbiology and Infection 26 (2020) 1259.e5e1259.e7 Contents lists available at ScienceDirect Clinical Microbiology and Infection journal homepage: www.clinicalmicrobiologyandinfection.com Research note Ibuprofen use and clinical outcomes in COVID-19 patients E. Rinott 1, E. Kozer 2, 3, Y. Shapira 3, 4, A. Bar-Haim 5, I. Youngster 3, 6, * 1) Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Paediatric Emergency Unit, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel 3) Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 4) Division of Internal Medicine, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel 5) Molecular Laboratory, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel 6) Paediatric Infectious Diseases, Shamir (Assaf Harofeh) Medical Centre, Zerifin, Israel 2) a r t i c l e i n f o a b s t r a c t Article history: Received 12 May 2020 Received in revised form 3 June 2020 Accepted 6 June 2020 Available online 12 June 2020 Objective: It was recently suggested that ibuprofen might increase the risk for severe and fatal coronavirus disease 2019 (COVID-19) and should therefore be avoided in this patient population. We aimed to evaluate whether ibuprofen use in individuals with COVID-19 was associated with more severe disease, compared with individuals using paracetamol or no antipyretics. Methods: In a retrospective cohort study of patients with COVID-19 from Shamir Medical Centre, Israel, we monitored any use of ibuprofen from a week before diagnosis of COVID-19 throughout the disease. Primary outcomes were mortality and the need for respiratory support, including oxygen administration and mechanical ventilation. Results: The study included 403 confirmed cases of COVID-19, with a median age of 45 years. Of the entire cohort, 44 patients (11%) needed respiratory support and 12 (3%) died. One hundred and seventynine (44%) patients had fever, with 32% using paracetamol and 22% using ibuprofen, for symptom-relief. In the ibuprofen group, 3 (3.4%) patients died, whereas in the non-ibuprofen group, 9 (2.8%) patients died (p 0.95). Nine (10.3%) patients from the ibuprofen group needed respiratory support, compared with 35 (11%) from the non-ibuprofen group (p 1). When compared with exclusive paracetamol users, no differences were observed in mortality rates or the need for respiratory support among patients using ibuprofen. Conclusions: In this cohort of COVID-19 patients, ibuprofen use was not associated with worse clinical outcomes, compared with paracetamol or no antipyretic. E. Rinott, Clin Microbiol Infect 2020;26:1259.e5e1259.e7 © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. Editor: L. Scudeller Keywords: Antipyretics Coronavirus disease 2019 Disease severity Ibuprofen Paracetamol