The Food and Drug Administration (FDA) has issued a statement regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDS) in patients with coronavirus disease 2019 (COVID-19).

According to the agency, there is not enough scientific evidence to link the use of NSAIDs to worsening symptoms of COVID-19. Reports about a possible association began after a letter was published in the journal Lancet Respiratory Medicine. The authors hypothesized that since ibuprofen increases an enzyme (angiotensin-converting enzyme 2 [ACE2]) through which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binds to target cells, its use could potentially “facilitate infection with COVID-19”. 

The article also suggested that patients with diabetes and those with cardiovascular conditions being treated with ACE inhibitors and/or angiotensin II type-1 receptor blockers (ARBs) may be at increased risk of severe illness if they are infected with COVID-19. In response, the American Heart Association, the Heart Failure Society of America, and the American College of Cardiology (ACC) issued a joint statement urging patients with cardiovascular disease diagnosed with COVID-19 to continue taking their ACE inhibitors and ARBs as prescribed. The statement also highlighted the need for additional research in order to “dispel misinformation.”  

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The FDA noted that the labeling for all prescription NSAIDs includes a warning that treatment can mask inflammation and fever, thereby diminishing the utility of diagnostic signs in detecting infections. At this time, the agency continues to advise that patients take their prescription medications as directed and refer to healthcare professionals if they have concerns. There are a number of over-the-counter (OTC) pain and fever reducers available for patients who wish to avoid NSAIDs; the product’s Drug Facts Label includes information on whether a product contains an NSAID. 

The FDA is investigating the matter further and plans to provide updates to the public as more information becomes available.

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