Some early reports addressing the Covid-19 pandemic instructed individuals to load up on anti-inflammatory fever reducers like ibuprofen and corticosteroids, in light of specific antiviral treatment. However, in the short months following the global outbreak, this suggestion has become a polarizing one among the medical community.
On Tuesday, France’s minister of Solidarity and Health, Olivier Véran, issued a warning to the public about the regressive effects of anti-inflammatory drugs and cortisol-like steroid medications. Burgeoning research suggested that these agents could be an aggravating factor in Covid-19 infections. To attend a developing fever, the health minister recommends patients take generic forms of acetaminophen.
This advice seemed to be a reaction to a recent study published in The Lancet. In it, researchers hypothesized that anti-inflammatory medications designed to treat hypertension in diabetes might contribute to severe and fatal manifestations of Covid-19.
“We’re looking into this to give further guidance.” World Health Organization spokesman, Christian Lindmeier said of the new paper. “In the meantime, we recommend using paracetamol and do not use ibuprofen as self-medication. That’s important.”
Contrary evaluations are starting to appear more frequently
University of Nebraska infectious disease specialist, Dr. Andre Kalil is skeptical of the adverse impact corticosteroids have on the immune system and is even more so in regards to its much weaker manifestation, ibuprofen.
“There is no clinical data and there are no studies in humans showing that ibuprofen or paracetamol are harmful or beneficial in those with COVID-19 infection,” Kalil said on the back of the WHO update. “Absolutely none. This is not my opinion. It’s just a fact.”
As intervention measures are being developed internationally, now is a good time to familiarize ourselves with an important epidemiological qualifier: biological plausibility. The term denotes proposed causal associations derived from previously established knowledge, that have yet to be directly substantiated.
In relation to the punitive medication and Covid-19 relationship, ibuprofen and corticosteroids have been independently studied to hinder the immune system’s response to infection.
Patients involved in preceding analysis who suffered from the two other most common novel coronaviruses — severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) — did not evidence increased mortality rates after taking corticosteroids but their viral loads, (which measures their recovery rate and their ability to infect others) were reduced at a slower rate.
Currently, Kalil is conducting federally funded clinical trials every week comprising 400 subjects to test whether existing medicines can successfully treat COVID-19.
The experiments will be conducted in more than 40 sites in the United States and 20 locations in other countries. By the end of the trial period, Dr. Kalil will determine the degree to which antiviral medications like remdesivir, can effectively shorten the severity of symptoms in patients with pneumonia induced coronavirus.
“Public health officials need to avoid making statements that don’t reflect evidence we have,” Nyhan said. Sometimes, officials do need to rely on educated guesses in a crisis, “but this doesn’t seem to be a decision that had to be made today. The crisis is confusing enough without public health authorities making it worse.,” added Dartmouth political scientist, Brendan Nyhan,