Britons with coronavirus symptoms are being warned not to take ibuprofen after a four-year-old girl became seriously ill after being given the painkiller.
Amelia Milner, four, was given ibuprofen by her parents after she became ill with a cough and a fever – the hallmark symptoms of the deadly infection.
But, instead of making her feel better, the painkiller made her temperature spike and she began shaking, panting, couldn’t keep her eyes open and vomited, according to her step-father, Dan Collins.
Mr Collins’ warning comes as the NHS today withdrew its official advice that told coronavirus patients to take ibuprofen to fight off symptoms – instead infected Brits should only rely on paracetamol.
French health minister Olivier Véran prompted questions over the NHS advice when he said anti-inflammatories, such as ibuprofen, could ‘aggravate the infection’.
Other leading medics echoed his concerns, admitting the over-the-counter drug may dampen the immune system and even slow down recovery.
Experts say the popular pill works by reducing inflammation, which is the immune system’s natural response to an infection. Therefore, preventing it from happening could make people less able to fight off an illness.
In a moving Facebook post, Mr Collins shared a photo of Amelia and warned: ‘If your child has symptoms of coronavirus, DO NOT give them ibuprofen.’
Amelia was given ibuprofen because her parents were unable to get any Calpol. She has not been tested for coronavirus because she is not in hospital.
Amelia Milner (pictured), 4, who has suspected coronavirus, was given ibuprofen and experienced a raft of problems including a spike in temperature and vomiting
Amelia at the wedding of her mother, Maddie, and step-father, Dan. Paramedics attended Amelia and told her mother and step-father not to give her any more ibuprofen. The first warning came a couple of days ago from France’s health minister, Olivier Veran
WHY COULD IBUPROFEN WORSEN CORONAVIRUS SYMPTOMS?
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body’s production of certain natural substances that cause inflammation, and is used to decrease pain or a fever.
Experts say paracetamol should be a first choice because:
1. Ibuprofen may dampen the body’s immune response to infection because it is has anti-inflammatory effects. This may slow the recovery process, Professor Ian Jones, a virologist at the University of Reading, said.
2. He added that it is likely the coronavirus acts in a similar way to SARS, in that it reduces an enzyme which regulates salt and water in the blood. This can lead it pneumonia. Ibuprofen may aggravate this, Professor Jones said.
2. NSAIDs can cause stomach irritation and stress on the kidneys if taken over a long period of time. This could be exacerbated in those who already have kidney or stomach problems brought on by severe illness, such as COVID-19, experts said.
‘Within an hour of giving it to her, she dropped dramatically,’ Dan told the Manchester Evening News.
‘She was panting while trying to breathe, her heart rate was very rapid, she couldn’t keep her eyes open, couldn’t lift her head up, her body was shaking, she started being sick on herself and her temperature had risen to 39.4C (a temperature of 37.5C or more is high).
‘We called back up and the NHS sent out an emergency ambulance, once the paramedics got here they managed to bring her temp and stats down a bit, they’re still higher than normal but not dangerously high anymore.
‘Now she’s back on Calpol, she’s back to just being her poorly self. The paramedics only told us while here that we’re not to give her ibuprofen.’
Amelia’s mother Maddie, also mother to eight-year-old Katie, said she’s ‘never seen her daughter as poorly in her life’ and they are now self-isolating.
Speaking to the MEN, she said: ‘I had her in bed with me last night so I could keep an eye on her, she was up all night coughing and wheezing and with a high fever still, today has been the same.
‘She’s also been ill for seven days now and shows no sign of being better, but with them not testing we won’t know if it is for definite or not.
‘They didn’t mention testing, as I’m aware if you’re well enough to stay home and self isolate then they aren’t testing, they’re only testing those with underlying health conditions that are ending up admitted to hospital with it, she added.’
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking the body’s production of certain natural substances that cause inflammation.
This effect helps to decrease pain or fever, which most COVID-19 patients are known to suffer.
However, some doctors warn the anti-inflammatory effects may dampen the body’s response to infection and slow recovery.
They may also fuel a process in the body that leads to pneumonia, a severe result of COVID-19 which can lead to death.
Dr Amir Khan, star of the Channel 5 show GPs Behind Closed Doors, has also warned about the use of ibuprofen.
He says that despite anti-inflammatories like ibuprofen being important drugs that are used by millions of people to treat pain, different types of arthritis, headaches, sore throats and colds, they ‘can have a depressive effect on parts of our immune systems’ – and that is where the danger lies with coronavirus.
Amelia Milner (left) with her sister Katie (right), before she fell ill with suspected coronavirus
In a moving Facebook post, Mr Collins shared a photo of the poorly four-year-old and issued a warning about ibuprofen
HOW DO IBUPROFEN AND PARACETAMOL WORK?
Paracetamol and ibuprofen are two of the most common painkillers.
The two drugs work in different, but complementary ways.
Ibuprofen blocks the production of various chemicals in the body.
These include prostaglandins, which are produced in response to injury or disease and cause inflammation.
Ibuprofen taken as pills or in liquid form numbs the site of pain and reduces inflammation, and is widely used for arthritic pain.
It has a relatively low level of side effects, although it can cause stomach bleeding, kidney damage, allergic reactions.
It should not be taken by people who are allergic to aspirin.
Paracetamol also blocks prostaglandin, but only in the brain and spinal cord.
It reduces temperature by acting on the area of the brain responsible for controlling temperature.
Side effects are rare but can include a rash or swelling.
‘When it comes to taking them to help ease the symptoms of the common cold, we do not really have to worry about this slight but important reduction in the strength of our immune systems: We are very unlikely to develop complications from the common cold, let alone die from it,’ he told Al Jazeera.
‘But we need our immune system in top working order in order to battle the coronavirus and win.’
He explained that when the virus enters the body, it causes mild to severe respiratory problems, a high fever, cough and, potentially, multi-organ dysfunction, which can lead to death.
The body releases immune cells in response to the virus and when they come into contact with the virus, they then trigger ‘a much bigger immune response, which involves inflammatory chemicals being released’.
We need these inflammatory chemicals to help tackle the virus in the medium to long term,’ said Dr Khan.
‘It is the effectiveness of these chemicals that decides whether a person develops complications from the coronavirus or makes a full recovery.’
The NHS no longer says coronavirus patients should take ibuprofen for symptoms of the deadly infection amid a row over the cheap painkiller.
Until last night, its official advice website named paracetamol and ibuprofen as two ‘everyday’ painkillers that could fight off a fever and cough.
Its official advice website now only advises Brits suspected of having the deadly illness to take paracetamol, which is not an anti-inflammatory.
Olivier Véran, France’s health minister, claimed the over-the-counter medication– which the NHS says could help – may aggravate the infection
French health minister and doctor Olivier Véran claims that the over-the-counter medication may aggravate symptoms of COVID-19 (pictured, his original tweet in French and a translation to English)
COMBINATION OF PARACETAMOL AND IBUPROFEN CAN SLOW DOWN RECOVERY, STUDY FINDS
Researchers from the University of Southampton found in 2013 that a combination of paracetamol and ibuprofen is inadvisable, and ibuprofen may even slow down recovery.
Professor Professor Paul Little, of the University of Southampton, who led the study, said treatment with ibuprofen could contribute to the progression of the illness.
He said: ‘This may have something to do with the fact the ibuprofen is an anti-inflammatory.
‘It is possible that the drug is interfering with an important part of the immune response and leads to prolonged symptoms or the progression of symptoms in some individuals.
‘Although we have to be a bit cautious since these were surprise findings, for the moment I would personally not advise most patients to use ibuprofen for symptom control for coughs, colds and sore throats.’
There are also concerns that the cheap drug could contribute to kidney problems or pneumonia, which severe coronavirus patients may develop and die of.
Professor Ian Jones, virologist at the University of Reading, said: ‘The advice relates to Ibuprofen’s anti-inflammatory properties, that is, it dampens down the immune system, which may slow the recovery process.
‘In addition, it is likely… that the virus reduces a key enzyme which part-regulates the water and salt concentration in the blood and could be part of the pneumonia seen in extreme cases. Ibuprofen aggravates this while paracetamol does not.’
The updated NHS guidance comes after Mr Véran, who is in charge of France’s coronavirus battle, warned that taking ibuprofen may worsen symptoms of the deadly coronavirus.
The neurologist tweeted: ‘The taking of anti-inflammatories (ibuprofen, cortisone, …) could be a factor in aggravating the infection.
‘In case of fever, take paracetamol. If you are already taking anti-inflammatory drugs or in doubt, ask your doctor for advice.’
Public Health England said there is ‘not currently enough information on ibuprofen use and COVID-19’, but that patients should not be put off using it.
WHAT ARE THE CORONAVIRUS SYMPTOMS?
Like other coronaviruses, including those that cause the common cold and that triggered SARS, COVID-19 is a respiratory illness.
- The most common symptoms are:
- Dry cough
- Shortness of breath
- Difficulty breathing
Although having a runny nose doesn’t rule out coronavirus, it doesn’t thus far appear to be a primary symptom.
Most people only become mildly ill, but the infection can turn serious and even deadly, especially for those who are older or have underlying health conditions.
In these cases, patients develop pneumonia, which can cause:
- Potentially with yellow, green or bloody mucus
- Fever, sweating and shaking chills
- Shortness of breath
- Rapid or shallow breathing
- Pain when breathing, especially when breathing deeply or coughing
- Low appetite, energy and fatigue
- Nausea and vomiting (more common in children)
- Confusion (more common in elderly people)
- Some patients have also reported diarrhea and kidney failure has occassionally been a complication.
Avoid people with these symtpoms. If you develop them, call your health care provider before going to the hospital or doctor, so they and you can prepare to minimize possible exposure if they suspect you have coronavirus.