Abstract

COVID-19, PAIN AND ANTIINFLAMMATORY AGENTS: WHAT HAS CHANGED?

Ozgur Karcioglu*, Behlul Bas, Mandana Hosseinzadeh, Asghar Kolahforoush, Ilknur Simsik and Selman Yeniocak

Abstract

Introduction: Fever, headache, muskuloskeletal pain are symptoms recorded commonly in patients with COVID-19. Although preferred as the first line in these conditions, nonsteroidal anti-inflammatory drugs (NSAID) are questioned the pandemic era, with the concerns of upregulation of ACE2 receptors. This review aims to shed light to this aspect of COVID-19 clinical course, with a special emphasis on the use and safety of NSAIDs in the pandemic era. Methods: Currently available literature on the nature of painful and inflammatory conditions related to COVID-19, and NSAID use was identified by searches of available databases. Usage of these agents in the management of patients with a diagnosis or suspicion of COVID-19 was addressed in the literature data found by searches of databases. The findings were presented in different subheadings. Results: There are not well-designed, population-based randomized, controlled studies demonstrating the net effects and safety situation of NSAIDS specifically in patients with a definitive or presumptive diagnosis of COVID-19. Paracetamol and the NSAID group “profens” (ibuprofen / ketoprofen / dexketoprofen / flurbiprofen) are active agents effective in all viral infections including pandemic ones. Conclusion: Safety precautions related to COVID-19 have not been supported by evidence-based studies. COVID-19 patients can benefit from effects of paracetamol and NSAIDs following specific precautions.

Keywords: COVID-19, treatment, pain management, nonsteroidal anti-inflammatory drugs, ACE2 receptors. Ibuprofen.