Abstract
Ibuprofen is a common over-the-counter drug taken for pain relief. However, recent studies have raised concerns about its potential toxic effect with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been proposed that ibuprofen may increase levels of angiotensin-converting enzyme 2 (ACE2), the human receptor for SARS-CoV-2 infection. Therefore, paracetamol is suggested as an alternative to ibuprofen for treating COVID-19 symptoms. Nevertheless, the relationship between intake of paracetamol or ibuprofen and either susceptibility to infection by SARS-CoV-2 or modulation of cellular ACE2 levels remains unclear. In this study, we combined data from human medical records and cells in culture to explore the role of the intake of these drugs in COVID-19. Although ibuprofen did not influence COVID-19 infectivity or ACE2 levels, paracetamol intake was associated with a lower occurrence of COVID-19 in our cohort. We also found that paracetamol led to decreased ACE2 protein levels in cultured cells. Our work identifies a putative protective effect of paracetamol against SARS-CoV-2 infection. Future work should explore the molecular mechanisms underlying the relationship between paracetamol and COVID-19.
Highlights
IntroductionDue to their analgesic and antipyretic properties, ibuprofen [(2RS)-1[4-(2-methyl propyl) phenyl] propionic acid (BP. 2004)] and paracetamol ( known as acetaminophen or N-acetyl-para-aminophenol) are the most frequently used over-the-counter drugs to relieve pain [1,2,3]
Due to their analgesic and antipyretic properties, ibuprofen [(2RS)-1[4-(2-methyl propyl) phenyl] propionic acid (BP. 2004)] and paracetamol are the most frequently used over-the-counter drugs to relieve pain [1,2,3]
These drugs are being used in treatment for coronavirus disease 2019 (COVID-19), a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Summary
Due to their analgesic and antipyretic properties, ibuprofen [(2RS)-1[4-(2-methyl propyl) phenyl] propionic acid (BP. 2004)] and paracetamol ( known as acetaminophen or N-acetyl-para-aminophenol) are the most frequently used over-the-counter drugs to relieve pain [1,2,3]. 2004)] and paracetamol ( known as acetaminophen or N-acetyl-para-aminophenol) are the most frequently used over-the-counter drugs to relieve pain [1,2,3]. Ibuprofen has been shown to affect the gastrointestinal and cardiac systems while paracetamol is often used as an alternative for patients with issues in these systems [3]. These drugs are being used in treatment for coronavirus disease 2019 (COVID-19), a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The molecular mechanisms that allow the entry of SARS-CoV-2 into human cells include binding of the viral spike (S)
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