Some studies that have evaluated NSAID use and pneumonia have demonstrated an increased risk for
Worsening disease course
Longer duration of antibiotic therapy
Greater hospital length of stay
Studies regarding NSAIDs and pneumonia (in general, not specifically COVID-19) were more directed toward long term use Intermittent or short interval use have not been well studied
Note: To date there is no evidence that ibuprofen or NSAIDs are detrimental in the setting of COVID-19
At this time, FDA is not aware of scientific evidence connecting the use of NSAIDs, like ibuprofen, with worsening COVID-19 symptoms
The agency is investigating this issue further and will communicate publicly when more information is available
However, all prescription NSAID labels warn that “the pharmacological activity of NSAIDs in reducing inflammation, and possibly fever, may diminish the utility of diagnostic signs in detecting infections.”
US NIH Treatment Guidelines
Persons with COVID-19 who are taking NSAIDs for a co-morbid condition should continue therapy as previously directed by their physician
The Panel recommends that there be no difference in the use of antipyretic strategies (e.g., with acetaminophen or NSAIDs) between patients with or without COVID-19
Recommends that patients be advised to take paracetamol (acetaminophen) or ibuprofen in the setting of COVID-19 where antipyretics would help with management
Use lowest effective NSAID dose
When patients, carers or healthcare professionals are starting treatment for fever and/or pain in patients (adults or children) with confirmed or suspected COVID-19, all treatment options should be considered and selected based on the greatest benefit compared to potential harms using each medicine’s product information
Studies regarding NSAIDs and pneumonia (in general, not specifically COVID-19) were more directed toward long term use
Intermittent or short interval use have not been well studied
Patients should not stop NSAIDs without a discussion with their physicians, especially if NSAIDs used for treatment of chronic illness
Patients should continue low-dose aspirin for secondary prevention of cardiovascular disease
Anti-inflammatory effects require higher doses (1-4 g per day)
Low-dose aspirin for preeclampsia: ACOG recommends that when indicated, low-dose aspirin “should continue to be offered to pregnant and postpartum women” | In the setting of suspected or confirmed COVID-19, “modifications to care may be individualized”
NSAIDs may be associated with complications, particularly with chronic use and/or underlying health issues
Serious complications include: GI ulcers and consequent bleeding | Renal and liver injury
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