Treating COVID-19 with Anti-inflammatory Medications
October 24, 2022
Researchers and physicians are developing strategies to decrease the inflammatory response in the early stages of COVID-19 (1). One possibility is using anti-inflammatory drugs, like non-steroidal anti-inflammatory drugs (NSAIDs), as an early treatment. NSAIDs are commonly used worldwide to reduce pain or fever, e.g., ibuprofen, or to treat inflammatory diseases, such as osteoarthritis and rheumatoid arthritis.
NSAIDs inhibit the COX-1 and COX-2 proteins, which are essential for the formation of molecules called prostanoids. Prostanoids have many functions within the body, including involvement in inflammatory processes. There is emerging evidence that coronaviruses, including SARS-CoV-2, activate COX-1 and COX-2 genes, leading to increased prostanoids levels. Studies also suggest that prostanoids may be an important player in SARS-CoV-2 infection, and aiming to reduce prostanoids levels in the early stages of infection can be a useful treatment strategy.
Researchers are looking at different NSAID doses and regimens that could be applied as an early at-home COVID-19 treatment; however, these are often observational, small sample studies that involve other drugs combined with NSAIDs. Nevertheless, the results are encouraging and point to NSAIDs (especially COX-2 inhibitors) as a possible treatment for early COVID-19 that could help reduce disease progression, including severe disease.
A different group of anti-inflammatory drugs is corticosteroids, widely used to treat chronic inflammatory and autoimmune diseases. They have different molecular ways of suppressing inflammation to NSAIDs; thus, their effects on COVID-19 patients can also differ. The small amount of data that has been provided so far shows the use of systemic corticosteroids during the early phases of COVID-19 having delayed recovery and worse outcomes. On the flip side, using corticosteroids during late, inflammatory stages of severe COVID-19 can have a beneficial effect. Due to the small number of studies, optimal treatment regimens have not been defined.
While the authors of this scientific paper made recommendations regarding anti-inflammatory drug doses and treatment length for multiple early COVID-19 treatment strategies, patients should always consult their doctor regarding their COVID-19 treatment plan, as the timing, dose, and length of treatment is dependent upon a person’s individual medical profile, and should be considered against any other medications they may be taking.