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More people with fever and body aches are turning to nonsteroidal anti-inflammatory drugs (NSAIDs) 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.
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 US Food and Drug Administration 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, PhD, from Yale University School of Medicine in New Haven, Connecticut, and his team to examine the effect of NSAIDs on COVID-19 infection and immune response. Their findings were published online January 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.”
One theory is that NSAIDs alter susceptibility to infection by modifying angiotensin-converting enzyme 2 (ACE2). The drugs might also change the cell entry receptor for SARS-CoV-2, alter virus replication, or even modify the immune response.
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