Social media is aflutter with rumors about the impact of meds and supplements on COVID-19.
Clear up misinformation...and help reassure patients.
This is based on speculative reports...since the SARS-CoV-2 virus that causes COVID-19 gets into cells via ACE2 receptors, and ACEIs or ARBs might upregulate ACE2.
Tell patients the risk is HYPOTHETICAL at this point.
On the flip side, researchers are studying whether ACEIs or ARBs may make COVID-19 LESS severe...but it's still too soon to say.
For your patients on an ACEI or ARB, emphasize the importance of continuing it...especially in those with a recent heart attack, heart failure with reduced ejection fraction, or chronic kidney disease.
Be aware, this is also the current advice of the Am Heart Assn, Am Coll of Cardiology, Heart Failure Soc of Am, and others.
NSAIDs. A tweet from France's health minister spurred debate over whether NSAIDs increase the risk of severe COVID-19...since it's speculated that ibuprofen might upregulate ACE2.
But there's currently no evidence that NSAIDs worsen COVID-19.
For now, feel comfortable recommending NSAIDs when needed.
If patients ask what to use for aches or fever, generally recommend acetaminophen first...since we know NSAIDs have risks, especially in older patients or those with CV or renal disease.
Supplements. "Immune boosters," such as Airborne or Emergen-C...that can contain vit C, vit D, zinc, echinacea, etc...are in demand.
Ensure patients know there's no evidence yet that these or other supplements (elderberry, garlic, etc) prevent or treat COVID-19...but explain it's okay if patients want to try them.
Steer people toward handwashing, proper sleep, healthy diet, etc.
Get ACCURATE answers to other common questions in our chart, COVID-19 and Pharmacotherapy.
- Lancet Respir Med 2020;8(4):e21
- https://covid19treatmentguidelines.nih.gov/concomitant-medications/ (4-27-20)
- N Engl J Med Published online March 30, 2020; doi:10.1056/NEJMsr2005760
- https://newsroom.heart.org/news/patients-taking-ace-i-and-arbs-who-contract-covid-19-should-continue-treatment-unless-otherwise-advised-by-their-physician (4-27-20)
- www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19 (4-27-20)
Pharmacist's Letter. May 2020, No. 360502