Taking NSAIDs (Advil, Motrin) Won't Make a COVID Case Worse

Early on in the pandemic, experts debated whether taking non-steroidal anti-inflammatory drugs (NSAIDs) potentially worsened COVID-19 symptoms. But recent guidance and a new study suggest that taking medication like ibuprofen will not make an infection more severe.

In March 2020, the U.S. Food and Drug Administration (FDA) issued guidance clarifying that there was no clear scientific evidence linking NSAIDs, like ibuprofen, with worse COVID-19 outcomes.

"Since NSAIDs are used to treat the symptoms of headache, muscle achiness, stuffy sinuses, and cold and flu symptoms that occur as part of COVID-19, the fear early on kept people from taking medications that could help relieve their suffering," William W. Li, MD, the chief executive officer and medical director of the Angiogenesis Foundation, tells Verywell.

NSAIDs Did Not Make COVID Worse

The May study published in The Lancet Rheumatology journal further suggests that using NSAIDs during a COVID infection is safe.

For this study, researchers reviewed the data of 78,674 patients across 255 healthcare facilities in England, Scotland, and Wales who were admitted for diagnosed or suspected COVID-19 symptoms between January and August 2020.

They found that people who took NSAIDs before hospitalization, compared to people who didn't, were not more likely to experience or need:

• Critical care admission
• Invasive ventilation
• Non-invasive ventilation
• Supplemental oxygen
• Acute kidney injury

"The comment to me, besides the fact this is a really interesting and well-done study, is that we're still learning a lot about COVID-19," Scott Kaiser, MD, a board-certified geriatrician and director of geriatric cognitive health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center, tells Verywell.

How NSAIDs May Help Manage COVID-19 Symptoms

NSAIDs may also be helpful in managing patients who develop long-term COVID-19 symptoms.

Some who contract COVID-19 experience symptoms long after their initial infection. One report found that 30% of people in their study still experienced COVID-19 symptoms nine months after they first became sick. The most common symptoms were fatigue and the loss of smell or taste.

In an article published in ACS Chemical Neuroscience last December, Abdul Mannan Baig, MBBS, PhD, hypothesizes that if COVID-19 long-haulers experience low-grade inflammation, it may be beneficial to take NSAIDs under medical supervision to manage inflammation. "If found to be effective in clinical trials, nonsteroidal anti-inflammatory drugs and corticosteroids can be the next generation of drugs for long-haulers with CCS under clinical supervision," he wrote.

In addition to potentially managing long-haul COVID-19 symptoms, Li also wonders if NSAIDs could play a role in preventing this condition. "It would be incredibly useful to know if NSAIDs can lower the risk for patients with COVID from developing long COVID, or long hauler’s syndrome," Li says. "We believe long COVID is partly due to chronic inflammation, so early use of anti-inflammatory treatments could possibly be useful. 

Safer Option Than Steroid Medication

People with certain preexisting conditions may be more likely to take this group of medication in order to cope with chronic pain. "There are important groups of patients who rely on NSAIDs for pain relief, including those with inflammatory joint diseases, bone pain, gout, postoperative pain, and menstrual pain, who would otherwise have few non-opioid options for pain relief," they wrote.

If the chronic pain is linked to inflammation, taking anti-inflammatory medications could be important to manage their symptoms.

Like with NSAID usage, the use of steroid medication during COVID-19 is complicated. Research suggests that glucocorticoid therapy—which can be used to treat autoimmune diseases—suppresses the immune system, leaving people more susceptible to severe illness from COVID-19.

On the other hand, steroids like prednisone and dexamethasone have been used to treat severe cases of COVID-19 successfully, but could potentially be harmful as well. "Both beneficial and deleterious clinical outcomes have been reported with use of corticosteroids (mostly prednisone or methylprednisolone) in patients with other pulmonary infections," the National Institutes of Health says.

For people who have COVID-19 or live with chronic illness, deciding which anti-inflammatory medication to take could be complicated. "NSAIDs can lower inflammation and bring relief to patients through a mechanism that is different and safer than steroids," Li says. "That said, steroid use can be very effective in certain situations, so the decision between an NSAID and a steroid should always be discussed with your doctor."

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.