COVID-19 and the PIPPA Tamariki study: FAQ

In light of our recent announcement about COVID-19, here are answers to the most common questions we have been receiving.

Can I give my baby Ibuprofen?

If your baby has fever or pain, please use paracetamol first.

If your baby requires further medication you can use ibuprofen. If you are unable to access paracetamol you can also use ibuprofen. There are a lack of data concerning use of ibuprofen in children with COVID-19, but some hypothetical concerns have been raised. The PIPPA Tamariki doctors have reviewed the evidence of ibuprofen use in children with COVID-19 and believe it is safe to give. However due to the lack of evidence, and the hypothetical concerns, we have made the prudent decision that paracetamol should be used first.

Can I give my older child Ibuprofen?

If your child has fever or pain, please use paracetamol first. If your child requires further medication or paracetamol is unavailable, you can use ibuprofen. There are a lack of data concerning using ibuprofen in children with COVID-19, but some hypothetical concerns have been raised. The PIPPA Tamariki doctors have reviewed the evidence of ibuprofen in children with COVID-19 and believe it is safe to give. However due to the lack of evidence, and the hypothetical concerns, we have made the prudent decision that paracetamol should be used first.

For how long will I be using paracetamol instead of ibuprofen?

This will depend on the length of the COVID-19 pandemic in New Zealand, or if further evidence becomes available. It is likely that the pandemic will last some months. We are working with international colleagues to get evidence; however, this too will take some months. We will write to you to let you know when to start using ibuprofen again as the first line pain and fever medication.

Do I need to withdraw my baby from the study?

You do not need to withdraw. We’d really like you to stay in the study. It is very important for all babies, regardless of what medications they have had, to stay in the study.

Please continue to record any paracetamol and ibuprofen that you do give, and please continue to answer the questionnaires until your baby is 1 year old, and then complete the questionnaires when baby gets to 3 years old and 6 years old.

Has the study been a waste of time and effort?

No!

The information gained from the 1,487 babies already in the study is very useful, and will go a long way to answering our study questions about the safety of paracetamol and ibuprofen for babies who are less than 1 year old.

We plan to continue recruiting babies into the study once COVID-19 has settled down in New Zealand.

We will continue to review the evidence of ibuprofen and COVID-19.

Does my GP know that you are now recommending I give paracetamol?

Yes, we have sent a letter to your GP to inform him/her of this change.

What happens if my baby is admitted to hospital?

The hospital staff may choose to use ibuprofen; we are comfortable with this.

Have I damaged my baby by giving him/her Ibuprofen?

No. There are currently only a few paediatric cases of COVID-19 in New Zealand. We have taken this action prior to the disease being widespread in New Zealand. The risk is theoretical.

Is my baby at more risk of getting       COVID-19 due to using ibuprofen?

No. There is no increased risk to babies that have used ibuprofen in the past.

Why could ibuprofen influence COVID-19 infection?

The virus that causes COVID-19 enters the body via a receptor known as the ACE2 receptor. This receptor is more common in adult patients with high blood pressure, diabetes and who smoke. The receptor is also increased in those taking ibuprofen. Some believe that this may place adults with high blood pressure, diabetes or who smoke at increased risk if they have COVID-19 and take ibuprofen. This is a hypothetical risk and there is no evidence that this occurs in data collected from over 300,000 patients who have contracted COVID-19 worldwide. Importantly, children, particularly infants have immature and low numbers of these receptors. Thus, even were this risk true for adults, it is unlikely to apply to children.

 

Have another question?

Our team will be happy to answer; just get in touch via your local teams contact details.

Nga mihi,

The PIPPA Tamariki team