Beware unproven news

I have seen several people around the web posting that annti inflammatory like Ibuprofen make the virus worse, and to stick to Paracetamol. There is no proof of this anywhere. It is maybe not as effective, but apart from minimal increases in inflammatory processes if you have come off the drug suddenly and all the usual warnings about drugs, I see no proof being offered at all. Brian

Reply to
Brian Gaff (Sofa)
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- Reality Check

There is some *very vague* link between NSAIDs, like Ibuprofen, and the severity of lower respiratory tract infections but that is all.

For those prescribed or under Dr's orders to take Ibubprofen or other NASIDs should keep taking them as instructed. Certainly not stop without consulting their Dr.

For the rest of us an "abundance of caution" would suggest that using paracetamol rather than an NSAID might have a small benefit.

Reply to
Dave Liquorice

I hope I won't ned to take either.

Reply to
charles

+1

  • it is not always sensible to take anything. If one can still function (eat/drink/sleep/etc) and the fever is not /dangerously/ high there's the option of letting the fever help tackle the virus.

Reply to
Robin

NHS has actually tweeted something now.

BMJ had this:

Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists

BMJ 2020; 368 doi: doi.org/10.1136/bmj.m1086 (Published 17 March 2020)

Scientists and senior doctors have backed claims by France?s health minister that people showing symptoms of covid-19 should use paracetamol (acetaminophen) rather than ibuprofen, a drug they said might exacerbate the condition.

The minister, Oliver Veran, tweeted on Saturday 14 March that people with suspected covid-19 should avoid anti-inflammatory drugs. ?Taking anti-inflammatory drugs (ibuprofen, cortisone . . .) could be an aggravating factor for the infection. If you have a fever, take paracetamol,? he said.

His comments seem to have stemmed in part from remarks attributed to an infectious diseases doctor in south west France. She was reported to have cited four cases of young patients with covid-19 and no underlying health problems who went on to develop serious symptoms after using non-steroidal anti-inflammatory drugs (NSAIDs) in the early stage of their symptoms. The hospital posted a comment saying that public discussion of individual cases was inappropriate.

But Jean-Louis Montastruc, a professor of medical and clinical pharmacology at the Central University Hospital in Toulouse, said that such deleterious effects from NSAIDS would not be a surprise given that since 2019, on the advice of the National Agency for the Safety of Medicines and Health Products, French health workers have been told not to treat fever or infections with ibuprofen.

Experts in the UK backed this sentiment. Paul Little, a professor of primary care research at the University of Southampton, said that there was good evidence ?that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used?both respiratory or septic complications and cardiovascular complications.?

He added, ?The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications helps confirm that the association seen in observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complications.?

Ian Jones, a professor of virology at the University of Reading, said that ibuprofen?s anti-inflammatory properties could ?dampen down? the immune system, which could slow the recovery process. He added that it was likely, based on similarities between the new virus (SARS-CoV-2) and SARS I, that covid-19 reduces a key enzyme that part regulates the water and salt concentration in the blood and could contribute to the pneumonia seen in extreme cases. ?Ibuprofen aggravates this, while paracetamol does not,? he said.

Charlotte Warren-Gash, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine, said: ?For covid-19, research is needed into the effects of specific NSAIDs among people with different underlying health conditions. In the meantime, for treating symptoms such as fever and sore throat, it seems sensible to stick to paracetamol as first choice.?

Rupert Beale, an infectious diseases researcher at the Francis Crick Institute, had a warning on cortisone, however. ?Patients taking cortisone or other steroids should not stop them except on advice from their doctor,? he said.

The complex role that the immune system might play in covid-19 disease has been underscored by reports that Swiss drug company Roche has secured approval from China for its anti-inflammation drug Actemra (tocilizumab) to treat patients developing severe complications from covid-19.

Some doctors in Italy, including Paolo Ascierto of the Pascale Hospital in Naples, claim that they have had success treating severely ill patients with the drug, which blocks the key inflammatory molecule interleukin-6.

There is speculation that the drug might prevent fatal ?cytokine storms,? in which the immune system of seriously ill patients can cause organ failure.

bmj.com/content/368/bmj.m1086

I certainly don't hold the BMJ as perfect and often disagree with things published. But it is a respectable source to be taken into consideration.

Reply to
polygonum_on_google

Golly, that is a bit reasonable for Usenet!

Reply to
The Natural Philosopher

Listen to Inside health from last night on radio 4. There are of course always some grains of truth in these things, but the actual harm is not proven. Brian

Reply to
Brian Gaff (Sofa 2)

As posted here yesterday

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Foe some people Ibuprofen could make a bad situation worse given the large number of people in the UK hypertension and/or diabetes and are taking certain drugs for their condition.

Reply to
alan_m

That's a somewhat misleading summary.

The hypertension people largely aren't taking ibuprofen anyway, because it helps to cause hypertension. The ones who *may* be at risk are those taking ACEs and ARBs, which *may* make COVID-19 easier to catch/worse.

Reply to
Bob Eager

Ibuprofen is already not recommended for people with those conditions

Reply to
The Natural Philosopher

Whereas drinking gin and tonic *may* reduce the chances/severity of the disease ;-)

Reply to
The Natural Philosopher

Nothing is *ever* proved in science. The closest we can ever get is a solid correlation that is consistent with a hypothesis. It is even hard in the soft sciences like biology where there are so many factors.

Proof is only available in mathematics and only then if you state your starting axioms very carefully at the outset. There are some things that even mathematics cannot prove and remain internally self consistent.

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Reply to
Martin Brown

And it relieves the stress of worry caused by the panic. Whisky applied to the stomach is also effective. Applied internally, that is.

I suffer from hypertension, for which I take an ACE inhibitor and a diuretic, and I also have arthritis, so take a daily paracetamol to loosen me up first thing AM, with the occasional ibuprofen later in the day if my hands get too painful. I'll change the latter.

Went to my local Tesco at 8AM this morning. Very busy, but a great shortage of fresh veg, bread and milk. Empty shelves everywhere. Wines and spirits were OK though.

Reply to
Chris Hogg

But I haven't seen anything in The Lancet about that...

Reply to
Bob Eager

Not if you drink it in 'spoons ...

Reply to
Andy Burns

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