Journal of Islamic International Medical College (Mar 2023)
Efficacy of Paracetamol or Ibuprofen in The Management of COVID-19 Fever: A Systematic Review
Abstract
The Global outbreak of COVID-19 pandemic affected almost all countries and territories worldwide. The outbreak was first identified from Wuhan, China, in December 2019 and was declared a pandemic in March 2020. Virus incubation time is usually 7 days and initial symptoms includes fever, cough, flu, muscle fatigue and difficulty in breathing. Ibuprofen and paracetamol are the two most commonly used over the counter (OTC) drugs to treat fever due to COVID-19. Some researchers discouraged the use of ibuprofen initially due to possible adverse effects related with longevity of infection, increased morbidity, and mortality rate. This study aimed to compare the effectiveness of paracetamol and ibuprofen as anti-pyretic drugs to treat fever caused in COVID-19 infection. A systematic review of major databases i.e., PubMed, Cochrane library, Web of Science, Google scholar and ClinicalTrials.gov was performed, to screen the studies conducted on managing fever using paracetamol and ibuprofen. Review of the selected articles based on the inclusion/exclusion criteria was performed by two independent researchers. The titles of selected publications were screened for relevance to the preset criteria followed by review of the abstracts. Finally, the full-length articles were evaluated for the final selection of studies to be included. Outcomes of use of ibuprofen and paracetamol were estimated by analyzing selected case control and cohort studies. Overall, eleven observational studies were selected for the compilation of systematic review, based upon the preset inclusion/ exclusion criteria. All studies included adult COVID-19 patients both male and female from different age groups. Paracetamol users were compared with ibuprofen users and no adverse effects of ibuprofen were found related to longevity of infection, complications, increased mortality rate and ventilation support requirement, when treating fever or pain caused by COVID-19.However, further studies and randomized control trials need to be conducted to assess and compare the effectiveness of these drugs to manage fever caused by coronavirus disease.
