Ibuprofen and COVID-19
Currently, the question is being discussed whether taking the painkiller Ibuprofen exacerbates the progression of COVID-19. A correspondence by Basel researchers states that there are some indications of a negative effect, but no clear evidence of an adverse impact. More research is needed to investigate this hypothesis.
On 11 March 2020, researchers published a correspondence in the scientific journal The Lancet Respiratory Medicine addressing the question of whether patients with hypertension and diabetes are at increased risk of developing the coronavirus infection COVID-19.
To evaluate this question, they referred to three Chinese observational studies that had analyzed patient data from China. These suggest that hypertension, diabetes and cardiovascular diseases are more common in patients with severe or fatal cases of COVID-19 than in those with mild cases. Further studies have now emerged from China and Italy that support this suspicion.
As a result, the Basel researchers hypothesized that this may be due to drugs used to treat hypertension, diabetes and cardiovascular diseases. Here, the suspicion falls primarily on ACE inhibitors, which target the angiotensin-converting enzyme 2 (ACE2).
Information for researchers, not for patients
This suspicion, which was expressly formulated as a hypothesis, is aimed at scientists with a view to further investigation based on additional patient data. “It does not constitute a recommendation to use certain drugs or not. Patients should always follow the instructions given by their physicians,” says study author Professor Michael Roth, who leads a research group at the Department of Biomedicine of the University of Basel and University Hospital Basel.
In itself, the enzyme ACE2 is a very valuable protein that promotes tissue regeneration. Previous studies have shown that ACE inhibitors and angiotensin receptor blockers lead to increased formation of ACE2. Unfortunately, the coronavirus SARS-CoV-2 binds to this protein and uses it to enter cells, where it multiplies. According to Professor Michael Roth, similar relationships were described following the SARS pandemic of 2002-2003.
Some patients with cardiac disease, hypertension or diabetes are indeed treated with drugs that increase the amount of ACE2. “For that reason, we suggest further research into the use of these drugs in COVID-19 patients,” says Roth.
Lei Fang, George Karakiulakis, Michael Roth
Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?
The Lancet Respiratory Medicine (2020), doi: 10.1016/S2213-2600(20)30116-8
The article was revised on 17 March following an updated assessment.