Could Ibuprofen worsen disease for people with COVID-19?

The World Health Organization recommends that people suffering COVID-19 symptoms avoid taking ibuprofen, this is in light with French officials warning that anti-inflammatory drugs could worsen effects of the virus. The Lancet medical journal hypothesized that an enzyme boosted by anti-inflammatory drugs such as ibuprofen could facilitate and worsen COVID-19 infections.

Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels.

The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs). Hypertension is also treated with ACE inhibitors and ARBs, which results in an up-regulation of ACE2. ACE2 can also be increased by thiazolidinediones( medicines for treatment of type-2 diabetes) and ibuprofen. The increased expression of ACE2 would facilitate infection with COVID-19

[DOI:https://doi.org/10.1016/S2213-2600(20)30116-8]

This puts patients with hypertension and diabetes mellitus at risk. WHO recommends Paracetamol for the treatment of fever.