Paracetamol Is Associated with a Lower Risk of COVID-19 Infection and Decreased ACE2 Protein Expression: A Retrospective Analysis

Abstract

Ibuprofen is a common over-the-counter drug taken for pain relief. However, recent studies have raised concerns about its potential toxic effect with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been proposed that ibuprofen may increase levels of angiotensin-converting enzyme 2 (ACE2), the human receptor for SARS-CoV-2 infection. Therefore, paracetamol is suggested as an alternative to ibuprofen for treating COVID-19 symptoms. Nevertheless, the relationship between intake of paracetamol or ibuprofen and either susceptibility to infection by SARS-CoV-2 or modulation of cellular ACE2 levels remains unclear. In this study, we combined data from human medical records and cells in culture to explore the role of the intake of these drugs in COVID-19. Although ibuprofen did not influence COVID-19 infectivity or ACE2 levels, paracetamol intake was associated with a lower occurrence of COVID-19 in our cohort. We also found that paracetamol led to decreased ACE2 protein levels in cultured cells. Our work identifies a putative protective effect of paracetamol against SARS-CoV-2 infection. Future work should explore the molecular mechanisms underlying the relationship between paracetamol and COVID-19.

Factors Associated with Length of Hospital Stay among COVID-19 Patients in Saudi Arabia: A Retrospective Study during the First Pandemic Wave

“…The Saudi Ministry of Health reported that in suspicious cases paracetamol is the preferred agent for treating fever and pain [ 34 ]. Leal et al suggested paracetamol as an alternative to ibuprofen for treating COVID-19 symptoms [ 35 ]. Yasui et al reported that the available information suggests that zinc deficiency is related to increased severity of the COVID-19 [ 36 ].…”

Surface engineering of carbon microspheres with nanoceria wrapped on MWCNTs: a dual electrocatalyst for simultaneous monitoring of molnupiravir and paracetamol

“…[3][4][5] Moreover, PCM has been frequently used to reduce fever during the COVID-19 pandemic. [6][7][8] Abnormal MPV and PCM levels in the body can affect the immune system, which may lead to some diseases. Therefore, there is an urgent need to simultaneously monitor and detect these two drugs in human biological samples.…”

Egyptian perspectives on potential risk of paracetamol/acetaminophen-induced toxicities: Lessons learnt during COVID-19 pandemic

“…Paradoxically but interestingly, multiple organs, including the lungs, rely on the ACE2 enzyme as protective. SARS-CoV infection has been found in several investigations to downregulate ACE2 expression on cells, interrupting its protective physiological actions and causing severe organ destruction [29] , [30] , [31] , [32] , [33] , [34] .…”