Ibuprofen, other NSAIDs and COVID-19: a narrative review

Laughey, William; Lodhi, Imran; Pennick, Graham; Smart, Lucinda; Sanni, Olutoba; Sandhu, Suneet; Charlesworth, Bruce

doi:10.1007/s10787-023-01309-7

Cited by 13 publications

(8 citation statements)

References 66 publications

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“…However, the use of NSAIDs for COVID-19 treatment remains controversial. Early in the pandemic, concerns were raised about the potential for NSAIDs to worsen COVID-19 symptoms, but subsequent reviews and studies did not find conclusive evidence linking NSAIDs to worsened outcomes in COVID-19 patients [ 312 , 313 , 314 ]. Achieving an optimal balance between protective and adverse effects is crucial [ 315 ].…”

Section: Nsaids and Their Role In Subclinical Inflammation And Long C...mentioning

confidence: 99%

Exploring the Pathophysiology of Long COVID: The Central Role of Low-Grade Inflammation and Multisystem Involvement

Gusev,

Sarapultsev

2024

IJMS

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Long COVID (LC), also referred to as Post COVID-19 Condition, Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), and other terms, represents a complex multisystem disease persisting after the acute phase of COVID-19. Characterized by a myriad of symptoms across different organ systems, LC presents significant diagnostic and management challenges. Central to the disorder is the role of low-grade inflammation, a non-classical inflammatory response that contributes to the chronicity and diversity of symptoms observed. This review explores the pathophysiological underpinnings of LC, emphasizing the importance of low-grade inflammation as a core component. By delineating the pathogenetic relationships and clinical manifestations of LC, this article highlights the necessity for an integrated approach that employs both personalized medicine and standardized protocols aimed at mitigating long-term consequences. The insights gained not only enhance our understanding of LC but also inform the development of therapeutic strategies that could be applicable to other chronic conditions with similar pathophysiological features.

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Section: Nsaids and Their Role In Subclinical Inflammation And Long C...mentioning

confidence: 99%

Exploring the Pathophysiology of Long COVID: The Central Role of Low-Grade Inflammation and Multisystem Involvement

Gusev,

Sarapultsev

2024

IJMS

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“…Во время вспыхнувшей в 2020 г. пандемии COVID-19 в научном обществе были расхождения по поводу того, следует ли использовать НПВС, в частности ибупрофен, для купирования лихорадки и не ухудшает ли прием этих препаратов течение заболевания. За эти годы было набрано достаточно данных о том, что прием НПВС не повышает подверженность организма инфекции SARS-CoV-2, не ухудшает течение и прогнозы заболевания и не влияет на иммунный ответ после вакцинации [44]. В литературных источниках появляются новые данные о возможном антипролиферативном эффекте ибупрофена на раковые клетки.…”

Section: роль ибупрофена в педиатрииunclassified

Paracetamol and ibuprofen in the treatment of pain and fever in children: modern views on the choice of a drug

Zakharova,

Berezhnaya,

Pupykina

et al. 2023

Medicinskij sovet

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Paracetamol (acetaminophen) and ibuprofen are commonly used to relieve fever and pain in children. Their effects are similar, but differ in strength and mechanisms of action on the body. Acetaminophen, a para-aminophenol derivative, has antipyretic and analgesic properties. Despite the fact that paracetamol has been officially used as a drug for more than 75 years, its mechanism of biological action has not been sufficiently studied. In paediatric practice, paracetamol is more often used as an antipyretic, but in recent years, with the development of technology and emergence of new dosage forms on the market, it came into common use as an analgesic in many diseases, including oncological, rheumatological, etc. Ibuprofen is the most commonly used non-steroidal anti-inflammatory drug with pronounced analgesic and antipyretic properties. Ibuprofen, a non-selective inhibitor of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), affects the hypothalamic thermoregulatory center via inhibition of prostaglandin synthesis. In the paediatric population, the most common indications for the use of ibuprofen are fever, sore throat, ear pain, headache and toothache, post-traumatic and musculoskeletal pain, and inflammatory joint diseases. Paracetamol and ibuprofen are safe for use in paediatric practice, if dosing rules are observed, and are approved for use by the World Health Organization, FDA and other expert organizations. In addition, the emergence of new presentation forms of these drugs is most important in paediatrics.

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“…This observation aligns with outcomes from clinical trials conducted amid the COVID-19 pandemic. These trials and more recent meta-analyses suggest that utilising ibuprofen and other NSAIDs for anti-IL-6 therapies could be a viable option, since NSAIDs do not cause increased rates of SARS-COV-2 infection or symptom severity when used for analgesic and antipyretic treatment during COVID-19 [16,17] . However, caution is advised when using ibuprofen and other NSAIDs to treat severe COVID-19 that requires hospitalisation [14,18] .…”

Section: Introductionmentioning

confidence: 99%

The wide spectrum anti-inflammatory activity of andrographolide in comparison to NSAIDs: a promising therapeutic compound against the cytokine storm

Low,

Suresh,

Zhou

et al. 2024

Preprint

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The challenges of the COVID-19 pandemic have highlighted an increasing clinical demand for safe and effective treatment options against an overzealous immune defence response, also known as the “cytokine storm”. Andrographolide is a naturally derived bioactive compound with promising anti-inflammatory activity in many clinical studies. However, its cytokine-inhibiting activity, in direct comparison to commonly used nonsteroidal anti-inflammatory drugs (NSAIDs), has not been extensively investigated in existing literature. The anti-inflammatory activities of andrographolide and common NSAIDs, such as diclofenac, aspirin, paracetamol and ibuprofen were measured on lipopolysaccharide (LPS) and interferon-γ induced RAW264.7 cells. The levels of PGE2, nitric oxide (NO), TNF-α & LPS-induced release of pro-inflammatory cytokines on differentiated human macrophage THP-1 cells were measured against increasing concentrations of andrographolide and aforementioned NSAIDs. The associated mechanistic pathway was examined on NFκB using flow cytometry on the human endothelial-leukocyte adhesion molecule (ELAM9) (E-selectin) transfected RAW264.7 cells with green fluorescent protein (GFP). Andrographolide exhibited broad and potent anti-inflammatory and cytokine-inhibiting activity in both cell lines by inhibiting the release of IL-6, TNF-α and IFN-γ, which are known to play a key role in the etiology of cytokine storm and the pathogenesis of inflammation. In comparison, the tested NSAIDs demonstrated weak or no activity against proinflammatory mediators except for PGE2, where the activity of andrographolide (IC50= 8.8 µM, 95% CI= 7.4 to 10.4 µM) was comparable to that of paracetamol (IC50= 7.73 µM, 95% CI = 6.14 to 9.73 µM). The anti-inflammatory action of andrographolide was associated with its potent downregulation of NFκB. The wide-spectrum anti-inflammatory activity of andrographolide demonstrates its therapeutic potential against cytokine storms as an alternative to NSAIDs.

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Ibuprofen, other NSAIDs and COVID-19: a narrative review

Cited by 13 publications

References 66 publications

Exploring the Pathophysiology of Long COVID: The Central Role of Low-Grade Inflammation and Multisystem Involvement

Exploring the Pathophysiology of Long COVID: The Central Role of Low-Grade Inflammation and Multisystem Involvement

Paracetamol and ibuprofen in the treatment of pain and fever in children: modern views on the choice of a drug

The wide spectrum anti-inflammatory activity of andrographolide in comparison to NSAIDs: a promising therapeutic compound against the cytokine storm

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