COVID-19 FAQ
Dear Whānau,
We hope you are staying safe and well. Here are answers to the most common questions we have been receiving about COVID-19:
Is ibuprofen safe in COVID-19 infection?
Ibuprofen is safe to use in COVID-19 infection.
The evidence surrounding ibuprofen use in coronavirus infection in children has been formally reviewed by an independent Safety Committee of the PIPPA Tamariki study, health authorities in England, the World Health Organization (WHO), the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) agency. Dr Ashley Bloomfield, New Zealand Director General of Health, has also supported using ibuprofen in COVID-19. All have stated that there is no evidence to support the suggestion that ibuprofen makes coronavirus infection in children worse. All have stated that ibuprofen can be used if required for symptoms of coronavirus. The PIPPA Tamariki study investigators have also reviewed the evidence and agree that ibuprofen is safe to use in coronavirus infection.
Why were previous concerns raised that ibuprofen might influence COVID-19 infection?
The virus that causes COVID-19 enters human cells 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. A theory was proposed in March 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 was a theory only, and has proven untrue with experience collected from the nearly 5 million patients who have contracted COVID-19 worldwide. Also reassuringly, children, particularly infants, have immature and low numbers of these receptors, meaning that the theory is unlikely to apply to children.
What is the scientific evidence that ibuprofen can influence COVID-19 infection?
Following publication of the above theory the relationship between ibuprofen and COVID-19 has been extensively investigated. Formal scientific reviews have been conducted by NICE, in the United Kingdom (UK), and the World Health Organization (WHO). Neither found any evidence of ibuprofen use resulting in more people catching COVID-19, or use of ibuprofen making the symptoms of COVID-19 worse.
What do the PIPPA Tamariki Safety Committee say?
The evidence regarding ibuprofen use in COVID-19 has been reviewed by the PIPPA Tamariki Safety Committee. This committee, independent of the PIPPA Tamariki study investigators, is composed of New Zealand paediatricians who are experts in paediatric respiratory disease and paediatric infectious diseases, a statistician, an a General Practitioner. The Safety Committee advised that participants in the ibuprofen arm of PIPPA Tamariki study should only use ibuprofen as required for fever and pain. They stated that this should occur regardless of any current or future New Zealand Government COVID-19 alert levels (i.e. ibuprofen is safe to be used in alert levels 1, 2, 3 and 4).
What do the PIPPA Tamariki study investigators say?
We have reviewed the evidence and agree with both the international health authorities and the PIPPA Tamariki Safety Committee that ibuprofen is safe to use in COVID-19. We are therefore asking that all children in the ibuprofen arm of the study only take ibuprofen as required for fever and pain and not take paracetamol.
Is paracetamol safe in COVID-19 infection?
Paracetamol is safe to use in COVID-19 infection.
What to do when my baby has fever or pain?
If your baby has fever or pain and you are in the ibuprofen (Brufen) arm of the study, please use ibuprofen. You should do this even if they may have COVID-19. You should not use paracetamol.
If your baby has fever or pain and you are in the paracetamol (Pamol) arm of the study, please use paracetamol. You should do this even if they may have COVID-19. You should not use ibuprofen.
These medications are equally safe to give in COVID-19 infection.
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.
Is my baby at more risk of getting COVID-19 due to using paracetamol?
No. There is no increased risk to babies that have used paracetamol in the past.
Can I give my older child ibuprofen?
It is safe to give older children ibuprofen for fever and pain.
Can I give my older child paracetamol?
It is safe to give older children paracetamol for fever and pain.
What happens if my baby is admitted to hospital?
During the COVID-19 pandemic paediatricians and emergency department doctors in New Zealand have been using both ibuprofen and paracetamol for patients with symptoms of possible COVID-19 without concern; we are comfortable with this and asking paediatricians and emergency department doctors to only give infants enrolled in the PIPPA Tamariki study their assigned medication.
Have another question?
We will be happy to answer; just get in touch with your local team
Ngā mihi,
The PIPPA Tamariki team