Ibuprofen and ACE inhibitors: higher corona risk?
Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.
More posts by Christiane Fux All content is checked by medical journalists.In times of the Corona crisis, a lot of unchecked information is ghosting through the network. One of them is that drugs like ibuprofen, ACE inhibitors or sartans could make it easier for the coronavirus to attack the body. What's wrong with the rumors?
Paracetamol rather than ibuprofen?
The World Health Organization (WHO) has withdrawn its warning against taking the pain reliever ibuprofen if a Sars-CoV-2 infection is suspected!
The background:
There are currently no meaningful studies that the intake of ibuprofen is actually linked to a higher mortality rate as a result of Covid 19 disease. In the medical journal "The Lancet", however, a team of researchers hypothesized that ibuprofen could have a negative impact on the course of an infection with the novel coronavirus.
Because this hypothesis of a more severe course of the disease did not seem entirely absurd, the World Health Organization (WHO) initially issued the provisional advice to use paracetamol as a preference for flu-like symptoms, fever and pain.
A few days later, the WHO withdrew its warning. The organization reported on Twitter: "Based on the information available today, the WHO does not advise against taking ibuprofen." Before this new assessment, WHO experts had assessed studies and interviewed doctors. Accordingly, there is no evidence that ibuprofen - apart from the usual side effects - has an excessively negative effect on Covid 19 patients.
How could ibuprofen and Co. promote Covid-19?
The said research group has hypothesized that certain drugs such as ibuprofen and antihypertensive ACE inhibitors or angiotensin II receptor blockers (sartans) can make it easier for the novel coronavirus to penetrate the body's cells.
The reason: SARS-CoV2 uses the enzyme ACE2 (angiotensin-converting enzyme 2) as an entry point. This protein sits on the surface of lung cells, among other things. Medicines such as ACE inhibitors, ibuprofen or glitazones against blood sugar increase the number of these ACE2 proteins on the cell surface. The hypothesis is that there are more entry ports that coronaviruses could penetrate.
The scientists had observed that among seriously ill Covid-19 patients, those who also suffered from high blood pressure and diabetes and were therefore taking appropriate medication were particularly common. However, this is not proof that the drugs are actually involved in the severe course of the disease.
Do not discontinue ACE inhibitors on your own!
Heart specialists in particular are now following this discussion with concern. While it is comparatively unproblematic to switch to other groups of medication for painkillers and fever reducers, the situation is different for medication to lower blood pressure.
The German Hypertension League has therefore already made a clear statement on the subject: “Under no circumstances should you stop without consulting your doctor!” Is the clear message here. Prof. Florian Limbourg from the Hannover Medical School also warns: “The possible harmful influence of antihypertensive drugs on susceptibility to virus infections is extremely speculative. On the other hand, antihypertensive drugs could save lives in severe cases. "
ACE inhibitors could even protect
In fact, there are even very convincing data for a protective effect of ACE inhibitors in severe lung failure, which is also suffered by seriously ill Covid 19 patients, according to the German Hypertension League. Several studies have shown that both an increase in ACE2, but also the blockade of ACE, for example through antihypertensive drugs, have a positive effect on the course.
The current state of knowledge in no way justifies stopping antihypertensive drugs. Cardiovascular high-risk patients in particular could subsequently suffer a heart attack or stroke.
Beware of fake news!
The discussion about ibuprofen was triggered by a Twitter post referring to the University of Vienna. However, she corrects on her Twitter account: “At the moment, messages are being spread in social media channels about ibuprofen and an alleged intensification of Covid-19 symptoms. This is fake news! There are no such studies at the University of Vienna. "
In our "Checklist: How to Recognize Corona Fake News" you can find out how you can protect yourself from false reports.
Positive side effect of lung failure?
In fact, at least ACE inhibitors could even have a positive effect on the course of Covid-19. "ACE2 is also produced in a soluble form and then swims in the blood as bait," writes the German Hypertension League. For example, higher amounts of it could bind viruses in the blood and thus significantly suppress infection of cells. But here, too, there is no conclusive data!
What does that mean in concrete terms?
More studies are needed to prove what exactly certain drugs can have on Covid-19.
Ideally, only take medication in consultation with your doctor!
Do not stop taking blood pressure medication on your own! Pre-existing illnesses increase the risk of a severe course of infection with the novel coronavirus! That is why protection against infection is so important!
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