Avoid anti-inflammatory drugs?

Q: “For the past few weeks, we have been seeing information circulating on social networks telling people with COVID-19 not to take anti-inflammatory drugs. But I was not able to confirm it. What about it? ” asks Ginette Larente, from Ferme-Neuve.
A: There has indeed been quite a bit of confusion around this issue in recent days. The information that circulates concerns in particular “non-steroidal anti-inflammatory drugs” (NSAIDs), an important category of drugs including ibuprofen (commercial brands such as: Advil, Motrin, etc.). As it is over the counter and very widely used to reduce pain and fever, in addition to of course inflammation, it is easy to understand the excitement that this may have caused.

What set the powder on fire is a “correspondence” published on March 11 in the medical journal The Lancet which made the hypothesis (I insist: this is an unproven hypothesis) that NSAIDs could have an indirect enzymatic effect which would provide a better “catch” for the virus of COVID-19 when it tries to enter the cells of our respiratory tracts, and therefore which would worsen the disease. There were also some previous results suggesting that NSAIDs may be harmful in lung infections, but they were patchy and did not rally many people in the scientific community .

However, this was enough for the French Minister of Health, Olivier Véran, to make a public outing and recommend avoiding ibuprofen on March 13. It was really after this press conference that the rumor gained momentum on social networks. And what followed had nothing to “untangle” the population …

The World Health Organization began by following in the footsteps of Mr. Véran, initially recommending the avoidance of ibuprofen and other NSAIDs. But she backed down on March 18 and no longer advises to avoid these drugs.

“To add to the confusion, says Alexandre Chagnon, hospital pharmacist and founder of the Questionpourunpharmacien.com site , Health Canada considered that there was insufficient information to demonstrate a link between NSAIDs and more serious COVID-19 infections, while [in Quebec, the National Institute of Excellence in Health and Social Services] mentioned that until we have more information, we should invite the population to avoid NSAIDs but to continue taking them if we have been taking them regularly for several weeks. ”

Note that the Food and Drug Administration in the United States responded by saying “not having seen scientific evidence showing a link between NSAIDs, such as ibuprofen, and a worsening of the symptoms of COVID-19” . This ministry does not recommend avoiding these drugs.

In short, we are in front of a sort of gray area. On the one hand, there is no convincing evidence that ibuprofen really worsens the disease. But on the other hand, we still have some data which raise the question: should we still apply the precautionary principle and avoid NSAIDs, time to clear up all this? Some believe it is, while others believe it is not.

For his part, Mr. Chagnon considers that “until we have a better idea of ​​the potential impact of NSAIDs on the evolution of COVID-19, people should avoid them and rather take [acetaminophen like Tylenol, Tempra, etc.] ”.

We also find the same story with epidemiology researcher Mahyar Etminan who, in a very recent interview on the website of the Faculty of Medicine at the University of British Columbia, concluded that “while waiting for to have more scientific knowledge on this issue, patients with moderate to moderate fever should use acetaminophen ”.

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COVID-19 raises a lot of questions. In order to respond to as many people as possible, science journalists have decided to join forces. The media members of the National Cooperative of Independent Information ( Le Soleil , Le Droit , La Tribune , Le Nouvelliste , Le Quotidien and La Voix de l’Est ), Québec Science and the Déclic Center team up to answer your questions. . You have some? Write to us . This project is made possible thanks to a contribution from the Chief Scientist of Quebec , who invites you to follow him on Facebook ,Twitter and Instagram .

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Clarification: an earlier version of this text was modified because it incorrectly stated that cortisone is a “non-steroidal” anti-inflammatory drug. My excuses.

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