- Fever in pediatric patients is usually managed using antipyretic medication like acetaminophen and ibuprofen;
- A review of case-control studies² proposed that NSAIDs could increase the risks of complications in cases of respiratory disease. The hypothesis lies in the inhibiting effect on cyclo-oxygenase, which diminishes white cells recruitment and making harder for the inflammation to resolve;
- No evidences have currently linked worsening of COVID-19 with the use of NSAIDs. According to the WHO, no negative effects beyond the usual ones, limiting the use of NSAIDs in specific populations, were reported;
- In children over 6 months of age with suspected virus, it is not contraindicated to use ibuprofen as an antipyretic. However, acetaminophen should be preferred;
- NSAIDs for chronic diseases should not be stopped, but patients should be assessed if COVID-19 symptoms were to appear.
Rieder’s practice point was written by Drug Therapy and Hazardous Substances Committee, Canadian Paediatric Society, Public Health Agency of Canada. It addresses the concern of NSAIDs use with COVID-19 that has been recently raised. The statements are in agreement with Health Canada and the WHO. INESSS made a litterature review to support their statements.
- Michael J Rieder, Geert ‘t Jong, Marina Salvadori, (March 24, 2020). Can NSAIDs be used in children when COVID-19 is suspected? Canadian Paediatric Society https://www.cps.ca/en/documents/position/can-nsaids-be-used-in-children-when-covid-19-is-suspected
- Voiriot G, Philippot Q, Elabbadi A, Elbim C, Chalumeau M, Fartoukh M, (June 3, 2019). Risks related to the use of non-steroidal anti-inflammatory drugs in community-acquired pneumonia in adult and pediatric patients. J Clin Med 2019;8:E786. doi:10.3390/jcm8060786
- INESSS, (April 4, 2020). Réponse rapide COVID-19: Utilisation des anti-inflammatoires non-stéroïdiens chez la clientèle pédiatrique. INESSS. https://www.inesss.qc.ca/fileadmin/doc/INESSS/COVID-19/COVID-19_Anti-inflammatoires_clientele_pediatrique.pdf