Course of COVID-19 in children under one year of age depending on the type of antipyretic therapy at the pre-hospital stage
et al., Pharmacology & Pharmacotherapy, doi:10.46393/27132129_2026_2_86-92, Jun 2026
2nd treatment shown to increase risk in
November 2020, now with p = 0.00000021 from 28 studies, but still recommended in 103 countries.
6,700+ studies for
220+ treatments. c19early.org
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Retrospective 86 infants under 1 year old comparing pre-hospital antipyretic therapy with Viburcol, paracetamol, and ibuprofen. No statistically significant differences were found between groups for hospitalization duration, disease severity, ICU transfer rate, oxygen saturation, or CT changes. There was a non-significant trend toward higher severity and ICU transfers in the paracetamol group. Viburcol is marketed differently and may have significant confounding by indication, with paracetamol and ibuprofen more likely used for more serious cases. Therefore the comparison between paracetamol and ibuprofen may be most informative, however potential confounding remains - ibuprofen is not licensed for the youngest group that may have higher risk (favors ibuprofen), and ibuprofen may be used as a second line treatment when paracetamol fails (favors paracetamol).
Paracetamol is also known as acetaminophen, Tylenol, Panadol, Calpol, Tempra, Calprofen, Doliprane, Efferalgan, Grippostad C, Dolo, Acamol, Fevadol, Crocin, and Perfalgan.
Study covers acetaminophen and ibuprofen.
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risk of ICU admission, 60.0% higher, RR 1.60, p = 0.53, treatment 8 of 28 (28.6%), control 5 of 28 (17.9%).
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mean case severity score, 18.8% higher, relative time 1.19, p = 0.22, treatment mean 1.71 (±0.81) n=28, control mean 1.44 (±0.81) n=28.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Vasilkova et al., 2 Jun 2026, retrospective, Russia, peer-reviewed, 2 authors, this trial compares with another treatment - results may be better when compared to placebo.
DOI record:
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"abstract": "<jats:p>Проведено исследование, посвященное изучению клинических проявлений инфекции SARS-CoV-2 у детей первого года жизни в период 2021–2023 гг. Установлено, что течение заболевания преимущественно было легким, без летальных исходов. Тяжелые случаи ассоциировались с наличием коморбидной патологии и сопровождались характерными изменениями лабораторных маркеров воспаления, а также уровня D-димера. При сравнительном анализе трех групп пациентов, выделенных в зависимости от вида жаропонижающей терапии на догоспитальном этапе (Вибуркол®, парацетамол, ибупрофен), статистически значимых различий по большинству клинических и лабораторных показателей не выявлено, за исключением повышенного уровня D-димера в группе ибупрофена. Тенденции к более тяжелому течению и более высокой частоте перевода в отделение реанимации в группе парацетамола не достигли статистической значимости и, вероятно, связаны с исходным тяжелым состоянием пациентов. Полученные нами данные свидетельствуют об отсутствии прямого негативного влияния парацетамола, ибупрофена или Вибуркола на течение COVID-19 у младенцев. Результаты исследования подтверждают безопасность использования как традиционных жаропонижающих средств, так и гомеопатического препарата Вибуркол®, а также необходимость индивидуализированного подхода к симптоматическому лечению лихорадки у детей первого года жизни с расширением возможности применения препаратов биорегуляционной терапии.</jats:p>\n <jats:p>A study was conducted to examine the clinical manifestations of SARS-CoV-2 infection in children under one year of age in the period 2021–2023. It was found that the course of the infection was predominantly mild, with no fatalities. Severe cases were associated with the presence of comorbid pathology and were accompanied by characteristic changes in laboratory markers of inflammation, as well as changes in the level of D-dimer. In a comparative analysis of three groups of patients with different antipyretic therapy at the pre-hospital stage (Viburkol®, paracetamol, and ibuprofen), no statistically significant differences were found in most clinical and laboratory parameters, except for an elevated D-dimer level in the ibuprofen group. The trends towards a more severe course and the frequency of transfer to the intensive care unit in the paracetamol group did not reach statistical significance and are likely related to the initial severity of the patients' condition. The findings suggest that paracetamol, ibuprofen, or Viburcol® do not have a direct negative impact on the course of COVID-19 in infants. The study results confirm the safety of using both traditional antipyretics and the homeopathic drug Viburcol®, as well as the need for an individualized approach to the symptomatic treatment of fever in infants, with an emphasis on the use of bioregulatory therapy.</jats:p>",
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