News Tough Pain Relief Choices in the COVID-19 Pandemic - WebMD

Feb. 1, 2021 -- More people with fever and body aches are turning to common pain relief drugs to ease symptoms, but the drugs have come under new scrutiny as investigators work to determine whether they are a safe way to relieve the pain of COVID-19 vaccination or symptoms of the disease.

Early on in the pandemic, French health officials warned that nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, could worsen coronavirus disease, and they recommended switching to acetaminophen instead.

The National Health Service in the United Kingdom followed with a similar recommendation for acetaminophen.

But the European Medicines Agency took a different approach, reporting "no scientific evidence" that NSAIDs could worsen COVID-19. The FDA also opted not to take a stance.

The debate prompted discussion on social media, with various reactions from around the world. It also inspired Craig Wilen, MD, from Yale University School of Medicine in New Haven, CT, and his team to examine the effect of NSAIDs on COVID-19 infection and immune response. Their findings were published online Jan. 20 in the Journal of Virology.

"It really bothered me that nonevidence-based decisions were driving the conversation," Wilen said. "Millions of people are taking NSAIDs every day and clinical decisions about their care shouldn't be made on a hypothesis."

British researchers, also questioning the safety of NSAIDs in patients with COVID-19, delved into National Health Service records to study two large groups of patients, some of whom were taking the pain relievers.

"We were watching the controversy and the lack of evidence and wanted to contribute," lead investigator Angel Wong, PhD, from the London School of Hygiene and Tropical Medicine, said.

And with nearly 11 million NSAID prescriptions filled in England alone in the past 12 months, the inconsistency was concerning.

The team compared COVID-19-related deaths in two groups: one group of more than 700,000 people taking NSAIDs, including patients with rheumatoid arthritis and osteoarthritis; and another of almost 3.5 million people not on the medication.

The investigators found no evidence of a harmful effect of NSAIDs on COVID-19-related deaths; their results were published online Jan. 21 in the Annals of the Rheumatic Diseases.

The results, they point out, are in line with a Danish study that also showed no evidence of a higher risk for severe COVID-19 outcomes with NSAID use.

"It's reassuring," Wong said, "that patients can safely continue treatment."