Here’s What We Know About Ibuprofen and COVID-19
By Kristen Fischer
- Experts say there's no clear evidence that ibuprofen makes COVID-19 worse.
- One thing specific to COVID-19 is that some lab experiments are showing that ibuprofen may boost the amount of ACE2 receptors that the virus uses to infect cells and could make the virus spread faster.
- But that's just theoretical.
The World Health Organization (WHO) has changed its stance on taking ibuprofen if you have COVID-19, but people are still scratching their heads over what they should take if or when they contract the virus.
After previously announcing that people with the virus shouldn't take ibuprofen to treat pain and fever, the WHO now says they don't advise against it.
The flip-flopping has a lot of people confused — especially those stocking up on medication in anticipation of getting the virus.
Dr. Otto O. Yang, a professor of medicine in the infectious diseases division at the David Geffen School of Medicine at UCLA, told Healthline there's no evidence that ibuprofen causes worsening of COVID-19, "although there is circulating misinformation to that effect."
Fever (Medication) Frenzy
The concern began after a study in The Lancet stated that ibuprofen boosts the angiotensin-converting enzyme 2 (ACE2), which may facilitate and worsen COVID-19. As a result, WHO originally warned most patients to stick with acetaminophen, which is also known as paracetamol or Tylenol.
Patients likely have increased ACE2 expression if they're treated with ACE inhibitors, angiotensin II type I receptor blockers (ARBs), or thiazolidinediones, the report noted. Those drugs are commonly taken by those with cardiovascular disease, hypertension, and diabetes. Ibuprofen can also increase ACE2, the study noted.
Anti-Inflammatory Drugs and COVID-19
The notion that anti-inflammatory drugs increase the risk of complications during fever or infection is "mostly theoretical," Yang said.
Medical experts debate whether or not reducing the inflammation that causes fever and muscle ache actually lowers the effectiveness of the immune response. On the flip side, patients who have worse symptoms may be more likely to take ibuprofen, and their outcome may have nothing to do with the medication itself.
"There are some clinical observations of small numbers of patients that suggest ibuprofen could slow recoveryTrusted Source from bacterial pneumonias or make some viral infections like chickenpox more severe, but these aren't careful prospective scientific studies," Yang said.
"Other publications have even argued that ibuprofen can be helpful in lung infectionsTrusted Source by reducing the amount of inflammation, which may be damaging to the lung," he added.
One thing specific to COVID-19 is that some lab experiments are showing that ibuprofen may boost the amount of ACE2 receptors that the virus uses to infect cells and could make the virus spread faster. But that is "purely theory that so far is not backed by clinical evidence in patients," Yang said.
It's unclear if what has been seen in the lab translates to the clinic, Yang added.
For example, ibuprofen may increase the ACE2 level in cells. "But that may be meaningless in a person if that increase is small, or if there is already so much receptor that adding more doesn't matter," Yang explained.
There's not enough evidence to show that ibuprofen could make COVID-19 worse, Rodney E. Rohde, PhD, a professor at Texas State University, told Healthline.
"I do not believe there is enough evidence due to a small sample size of patients," he said. "However, if one is concerned, then they may want to avoid those drugs or drug families."
Rohde explained that ibuprofen is known to diminish the response of the body's immune system. The inflammatory process is a vital component of the overall immune response, especially the second line of defense that triggers many third-line defense mechanisms, such as T and B cell responses, he said.
For now, Rohde said there's "no hard evidence" not to take over-the-counter or prescription pain medications. That said, Rohde advises people to talk to their doctors for more recommendations based on their individual health.
As for the National Institute of Allergy and Infectious Diseases, it gave a statement to Healthline and suggested people reach out to the Centers for Disease Control and Prevention (CDC) for updated COVID-19 treatment guidelines. "More research is needed to evaluate reports that ibuprofen and other over-the-counter anti-inflammatory drugs may affect the course of COVID-19," it said.
"Currently, there is no conclusive evidence that ibuprofen and other over-the-counter anti-inflammatory drugs increases the risk of serious complications or of acquiring the virus that causes COVID-19. There is also no conclusive evidence that taking over-the-counter anti-inflammatory drugs is harmful for other respiratory infections."
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By Aaron W Hunter
A chance discovery of a beautifully preserved fossil in the desert landscape of Morocco has solved one of the great mysteries of biology and paleontology: how starfish evolved their arms.
The Pompeii of palaeontology. Aaron Hunter, Author provided<h2></h2><p>Although starfish might appear very robust animals, they are typically made up of lots of hard parts attached by ligaments and soft tissue which, upon death, quickly degrade. This means we rely on places like the Fezouata formations to provide snapshots of their evolution.</p><p>The starfish fossil record is patchy, especially at the critical time when many of these animal groups first appeared. Sorting out how each of the various types of ancient starfish relate to each other is like putting a puzzle together when many of the parts are missing.</p><h2>The Oldest Starfish</h2><p><em><a href="https://www.biorxiv.org/content/10.1101/216101v1.full.pdf" target="_blank" rel="noopener noreferrer">Cantabrigiaster</a></em> is the most primitive starfish-like animal to be discovered in the fossil record. It was discovered in 2003, but it has taken over 17 years to work out its true significance.</p><p>What makes <em>Cantabrigiaster</em> unique is that it lacks almost all the characteristics we find in brittle stars and starfish.</p><p>Starfish and brittle stars belong to the family Asterozoa. Their ancestors, the Somasteroids were especially fragile - before <em>Cantabrigiaster</em> we only had a handful of specimens. The celebrated Moroccan paleontologist Mohamed <a href="https://doi.org/10.1016/j.palaeo.2016.06.041" target="_blank" rel="noopener noreferrer">Ben Moula</a> and his local team was instrumental in discovering <a href="https://www.sciencedirect.com/science/article/abs/pii/S0031018216302334?via%3Dihub" target="_blank" rel="noopener noreferrer">these amazing fossils</a> near the town of Zagora, in Morocco.</p><h2>The Breakthrough</h2><p>Our breakthrough moment came when I compared the arms of <em>Cantabrigiaster</em> with those of modern sea lilles, filter feeders with long feathery arms that tend to be attached to the sea floor by a stem or stalk.</p><p>The striking similarity between these modern filter feeders and the ancient starfish led our team from the University of Cambridge and Harvard University to create a new analysis. We applied a biological model to the features of all the current early Asterozoa fossils in existence, along with a sample of their closest relatives.</p>
Cantabrigiaster is the most primitive starfish-like animal to be discovered in the fossil record. Aaron Hunter, Author provided<p>Our results demonstrate <em>Cantabrigiaster</em> is the most primitive of all the Asterozoa, and most likely evolved from ancient animals called crinoids that lived 250 million years before dinosaurs. The five arms of starfish are a relic left over from these ancestors. In the case of <em>Cantabrigiaster</em>, and its starfish descendants, it evolved by flipping upside-down so its arms are face down on the sediment to feed.</p><p>Although we sampled a relatively small numbers of those ancestors, one of the unexpected outcomes was it provided an idea of how they could be related to each other. Paleontologists studying echinoderms are often lost in detail as all the different groups are so radically different from each other, so it is hard to tell which evolved first.</p>
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