A List To Save Lives: Drugs To Avoid Taking If You Become Covid-19 Positive
I’m writing this from Lubbock, Texas, where tonight on the news a doctor recommended NSAID use to manage symptoms associated with Covid-19, going directly against WHO guidelines. It got me thinking: people inside and outside the medical establishment are at a disadvantage here, during a paradigm shift, when so much established orthodoxy is to be thrown out the window so that everyone can do whatever it takes to survive.
I’ve written about supplements to take, and habits to avoid. This little list is geared toward the pros among us, but I hope laypeople will be able to have intelligent conversations with their doctors about these subjects as well. Please do not hesitate to start the conversation today.
The exponential growth of the infected population is already much further along than our testing data will show. Anything any of us can do to decrease the number of Covid-19 cases requiring hospitalization at this point is absolutely, completely necessary. Good luck, fellow humans.
ACE Inhibitors and ARBs
Coronavirus is tearing through the world at an exponentially increasing rate. A new paper published in the Lancet investigates the relationship between fatal Covid-19 cases and comorbid conditions, finding a strong link between Covid fatalities and two major classes of drugs commonly prescribed to patients suffering from kidney disease: ACE inhibitors and angiotensin II type-I receptor blockers (ARBs).
Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.
Ibuprofen and other NSAID drugs are also implicated by this study. If you’re currently prescribed to an ACE inhibitor or an ARB, it may be a good idea to contact your doctor immediately and talk to them about switching to calcium channel blockers because these drugs can accomplish the same goals (blood pressure control in the kidneys) as ACE inhibitors and ARBs but potentially without upregulating ACE2 receptors throughout the body. It may be too little too late, but if your life is on the line you don’t want to miss a chance to improve your odds.
NSAIDs (and paracetamol)
Drugs such as paracetamol (Tylenol, acetaminophen), ibuprofen (motrin, advil), and even aspirin have been shown to cause an explosive growth in the rate of multiplication of the coronavirus, which could lead to worsening symptoms and possibly even a patient collapse. It is likely that this is the result of the action these drugs take against the COX-2 pathway. A New York Times article vacillates on the issue of whether or not people should avoid taking these drugs, but ultimately despite the article’s equivocation on the issue of whether fever is a normal part of the reaction to the illness, there is hard science backing up the French Minister of Health’s claims:
Use of NSAIDs in patients with Covid-19
Serious adverse events related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported in patients with COVID19, possible or confirmed cases. We remind you that the treatment of a poorly tolerated fever or pain in the context of COVID19 or any other respiratory virosis is based on paracetamol, without exceeding the dose of 60 mg / kg / day and 3 g / day. NSAIDs should be banned.
Conversely, patients on corticosteroids or other immunosuppressants for a chronic pathology should not interrupt their treatment, unless otherwise advised by the doctor who follows them for this pathology.
This recommendation should be widely disseminated to all healthcare professionals.
(Translated with Google Translate after being located here)
At the end of the day, the issue is simple: providing NSAIDs for relief can provide temporary fever relief, but the risk is that — whether this is an ACE2 reaction, or whether it has to do with the COX-2 pathway these drugs are designed to inhibit, or whether the swelling they decrease is somehow holding the virus at bay — the virus will gain a major advantage when these drugs are used. Despite the unclear recommendations of the Times, it is a bad idea to take NSAIDs during a Covid-19 infection.
Don’t trust me? That’s fine! I encourage it even. I am, after all, a philosopher and not a doctor. Maybe you’d like to check Snopes. But, whatever their unproven rating is supposed to mean, I’m actually reporting a newly released guideline from the WHO here. It can be difficult for professionals in any field to break with long-held treatment guidelines, but in the face of a paradigm shift as monumental as Covid-19’s, laying off NSAIDs is probably one of the smallest sacrifices any of us will make to survive by the end of this. I won’t be taking NSAIDs or paracetamol.
To further address the debate, the research has been showing a relationship between increased asthma rates and NSAID overuse for decades at this point. At this point, the medical establishment’s longstanding acceptance of NSAID use seems to be preventing it from widely accepting a reasonable thesis on this. (UPDATE: the WHO have rescinded their recommendation against ibuprofen: https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms)
I’ll say this: I want to do everything possible to maximize my chances of avoiding a severe Covid-19 infection, and so I will not use NSAIDs.
One of the initial treatments for Covid-19 was large doses of corticosteroids. These are a class of drugs which operate by toning down the immune system. The thinking behind their administration to early Covid-19 victims was simple: tone down the immune system to diminish the “cytokine storm” which so often accompanies severe illnesses of this type.
The results were not pretty. Not only did milder cases not benefit from corticosteroid administration, there have been rumors of rapid deterioration under corticosteroid administration. At least one study is currently underway to further evaluate potential risks to patients treated with these drugs. If you go to the doctor and are prescribed a corticosteroid to treat covid-like symptoms, you should seek a second opinion. I was under the impression that there were data to support that ARDS patients declined more rapidly when treated with corticosteroids, but at the time of writing I cannot find the support I thought I had for this claim. If you’ve seen a study that shows this, please share it with me so that I can edit this section to reflect whatever the information comes back as.