Immune response against viral infection is cell mediated which releases many cytokines. It is clear that, in covid-19 infection level of cytokines is very high and called ' cytokine storm". Complications due to covid-19 infection is mostly due to this cytokines and can endanger the life by internal blood clotting. Other than remission of fever paracetamol has no anti-inflammatory action and this drug has no role on preventing release of cytokines. So use of paracetamol in this case will decrease fever escaping cytokines complications. On the other hand, along with action of decreasing fever NSAID can help to block formation of cytokines and thus prevents much of the complications due to covid-19 infection and decrease mortality. No doubt steroid is better than NSAID in this respect but many physician will hesitate to use steroid initially without confirmation. In all cases famotidine should replace PPI.
Dear Mujibur!
Please You also look at the articles:
https://www.pharmacytimes.com/view/researchers-physicians-warn-against-anti-inflammatory-use-for-covid-19-symptoms
https://www.bmj.com/content/bmj/368/bmj.m1086.full.pdf
https://jvi.asm.org/content/95/7/e00014-21
Article COVID-19 and NSAIDS: A Narrative Review of Knowns and Unknowns
Great query Dr. Mujibur Rahman
Some data raised NSAIDs safety concerns because of the supposed induction of ACE2 protein levels, the risk of bacterial superinfections and masking of disease symptoms. Also, it is suggested that mechanisms of how NSAIDs and corticosteroids may aggravate SARS-CoV-2 infection in the early stages of disease, it is through their interaction with prostaglandin synthesis and the renin-angiotensin-aldosterone system (RAAS), apart from the conventional pathway of immunosuppression at a time when the body needs it the most. But, more evidence is needed to gain a definitive understanding.
Article Anti-inflammatory drugs and the renin-angiotensin-aldosteron...
Article A narrative review of the potential pharmacological influenc...
Regards,
I generally avoid using NSAIDs in acute illnesses as these medications increase the risk of acute kidney injury and stress ulceration. I generally recommend paracetamol and simple cooling measures.
NSAID,s have some side effects particularly on renal function. In spite of these effects these drugs are being used in many cases particularly RA and other inflammatory diseases. Covid -19 complications ( like internal blood clotting) are much more dangerous than the side effects of these drugs.
Not at all . Paracetamol is safer than NSAID ( severe side effects and not to be used for ulcer , kidney pateints ) . HChQ is better than NSAID to reduce inflammation of Covid19 .