During the coronavirus pandemic declared by the WHO, striking anthropological phenomena are taking place, worthy of study, which the social sciences will evaluate when everything happens. Every time there is a situation that alarms the population, confusing information, partially erroneous, misinterpreted or with little scientific robustness immediately begin to flow. Given that we are talking about a new virus, about which more and more data is known (but there are few, for now), there are many questions that still cannot be answered. Any estimates made even by specialists may be inaccurate. For example, instructions for treating symptoms of COVID-19 change from day to day.
One of the information that circulates lately on social networks and the media is that ibuprofen and other anti-inflammatory drugs and to treat hypertension could aggravate or complicate the clinical pictures of COVID-19 in people of all ages.
Both the Spanish Medicine Association (AEMPS) and other scientific associations, such as the European Society of Cardiology (ESC) and the Spanish Society of Cardiology, have spoken out in this regard: no data indicates that ibuprofen aggravates COVID-19 infections. At least, for now, there is no official recommendation against the use of ibuprofen or other anti-inflammatories for people who need to take them occasionally or regularly. However, according to the statement issued by the AEMPS: “The possible relationship between exacerbation of infections with these drugs is being evaluated for the entire European Union in the Pharmacovigilance Risk Assessment Committee.”
Where does this information come from?
To this day, we already know how the coronavirus infects lung cells. There is a protein present on the surface of the cells of the pulmonary alveoli called ECA2. This protein acts as a receptor for the SARS-CoV-2 proteins, since both would have a high affinity for each other.
As well; sports cardiologist Manuel Marina, in line with what other doctors are saying these days, has expressed in a statement the following: ” People who take antihypertensive drugs to control ACEI-type blood pressure and especially ARA-II have a very high overexpression elevated of this receptor (ACE2) and, therefore, they are more susceptible to becoming infected and, if they do, to presenting more serious symptoms ”. In addition, it is also mentioned in the text that men and Caucasians would also present an overexpression of this receptor.
What is this information based on?
There are a handful of scientific articles that are reviewing the casuistry that we have just described. One of them, published in the journal The Lancet concludes the following: “We suggest that patients with heart disease, hypertension or diabetes who are treated with drugs that increase ACE2 have an increased risk of serious infection by COVID-19.”
In addition, they add a treatment alternative: “According to a search in PubMed on February 28, 2020, we did not find any evidence to suggest that antihypertensive calcium channel blockers increase the expression or activity of ACE2, therefore, these could be an appropriate alternative treatment in these patients ”.
Stopping these treatments could be much worse
Are these notes strong enough to advise against ibuprofen, as well as other anti-inflammatory and hypertension medications?
The doctor in Pharmacy, disseminator and professor at the Isabel I Marián García University (known as Boticaria García) believes that people who need anti-inflammatory or anti-hypertensive drugs should continue with the usual treatment: “In crises, an evaluation of the current situation taking into account the opportunity cost. If hypertensive patients abandon their medication for fear of complications from a respiratory disease that they do not yet have, the consequences for them could be much worse ”.
Regarding the position of scientific societies: “Let us not be more papist than the pope, and let us not ignore official positions. Furthermore, these change almost every day; This does not mean that within three days the recommendations will be different ”.
For a virus of which we still have (for some things) not much information, it is advisable to be cautious when advising against or not treatments that can be vital to address other pathologies.
“People who normally use this type of drug should continue to do so without fear,” explains Boticaria García to Muy Interesante. “Of course, with a head. Ibuprofen is a very safe drug, but it has very clear indications for use, and it has gastrolesive side effects that we must know ”.
In addition, there are no recommendations for the use of ibuprofen and other similar drugs during a COVID-19 process. “ To treat fever, what is indicated is the use of paracetamol ; but this, in turn, can cause liver damage. You have to use things properly, and under the advice of our doctor ”, he concludes.
The Lancet study reference:
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 2020 Published Online March 11, 2020.
