There is no evidence in the medical literature of adverse events when patients with COVID-19 take nonsteroidal anti-inflammatory drugs (NSAIDs), according to a new scientific brief from the World Health Organization.
However, there are also no studies testing NSAID use in patients with COVID-19, SARS (severe acute respiratory syndrome) or MERS (Middle East respiratory syndrome).
WHO conducted the rapid systematic review on March 20, searching Medline, Embase and the WHO Global Database for any studies discussing viral respiratory infections and NSAID use. While 73 studies were found (28 in adults, 46 in children and one in both), no studies researched the aforementioned listed diseases, which are all caused by coronaviruses.
Of the reviewed studies, most reported no severe adverse events from NSAID use or only reported mild or moderate adverse events. The brief states that the risk for ischemic and hemorrhagic stroke and myocardial infarction in adults is unknown when NSAID use and viral respiratory infections co-occur, and there was no evidence of worse quality-of-life measures or long-term survival when NSAIDs were taken. For children, there was moderate to high certainty of evidence that there was little to no difference in adverse events when taking either acetaminophen or ibuprofen for fever.
Along with the lack of coronavirus studies, the brief also mentions that there was only one randomized controlled trial with a large enough sample size to identify rare, severe adverse events. All the other studies were randomized controlled trials, but with smaller samples. The brief also states that it is likely that some study participants may not have had an infection that was viral in origin, and that not every study specified what NSAIDs patients received.
However, the brief concludes that “at present there is no evidence of severe adverse events, acute health care utilization, long-term survival or quality of life in patients with COVID-19, as a result of the use of NSAIDs.”