NSAIDs and covid-19: What have we learned?
In the early days of the coronavirus pandemic there was concern that the use of non-steroidal anti-inflammatory drugs might be harmful and people were advised to use only paracetamol for covid symptoms.
Since then, much has been learned and a WHO review concluded that there was no evidence of severe adverse events associated with the use of NSAIDs in covid-19.
Anti-inflammatory agents can be a double-edged sword – suppressing inflammation is not always desirable – explains Dr Colin Brown, a retired GP and researcher. However, covid-19 is a painful and distressing condition and doctors in New York found that indomethacin treatment relieved both the pain and the persistent cough.
It has been suggested that use of indomethacin early in the course of the disease might reduce the severity and duration of the disease by virtue of its ability to suppress cytokine storm.
Primary care physicians in New York originally selected indomethacin because of its antiviral properties that were first reported in 20062, notes Dr Brown.
There is, as yet, no clinical trial evidence to support the use of indomethacin or aspirin in treating the symptoms of early stage covid-19 infection. “It perplexes us that there has not yet been any research into this in primary care”, comments Dr Brown.
- WHO. The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Scientific Brief. 19th April 2020
- Amici C et al. Indomethacin has potent antiviral activity against SARS coronavirus. Antivir Ther 2006; 11: 1021–1030