Ibuprofen use and clinical outcomes in COVID-19 patients

Rinott, Ehud; Kozer, Eran; Shapira, Yonatan; Bar-Haim, Adina; Youngster, Ilan

OBJECTIVE: It was recently suggested that Ibuprofen might increase the risk for severe and fatal COVID-19 disease and should therefore be avoided in this patient population. We aimed to evaluate whether ibuprofen use in patients with COVID-19 was associated with more severe disease, compared to patients using paracetamol or no antipyretics. METHODS: In a retrospective cohort study of patients with COVID-19 from Shamir Medical Center, Israel, we monitored any use of ibuprofen from a week prior to diagnosis of COVID-19 throughout the disease. Primary outcomes were mortality and the need for respiratory support, including oxygen administration and mechanical ventilation. RESULTS: The study included 403 confirmed cases of COVID-19, with a median age of 45 years. Of the entire cohort, 44 patients (11%) needed respiratory support and 12 (3%) patients died. One hundred and seventy-nine (44%) patients had fever, with 32% using paracetamol and 22% using ibuprofen, for symptom-relief. In the Ibuprofen group, 3 (3.4%) patients died, while in the non-Ibuprofen group 9 (2.8%) patients died (P=0.95). Nine (10.3%) patients from the Ibuprofen group needed respiratory support, as compared with 35 (11%) from the non-Ibuprofen group (P=1). When compared to exclusive paracetamol users, no differences were observed in mortality rates or the need for respiratory support among patients using ibuprofen. CONCLUSIONS: In this cohort of COVID-19 patients, Ibuprofen use was not associated with worse clinical outcomes, compared to paracetamol or no antipyretic.