Are patients with hypertension and diabetes at increased risk for COVID-19?

The syndrome is called 'NSAIDs-Exacerbated Respiratory Disease'.

I felt equally proud and ashamed that the medical establishment officially diagnosed me as a NERD

https://en.wikipedia.org/wiki/NSAID_hypersensitivity_reactio...

They advise is to use acetaminophen.

It really comes down how covid-19 kills people, whether it is by directly attacking the body, or by triggering cytokine release syndrome (CRS).

In later case, medication that suppresses the immune system would be better, but in former case it could make things worse.

The relevant portion about ibuprofen, lightly edited to make it more readable, is:

> Coronaviruses bind to their target cells through ACE2. The expression of ACE2 is substantially increased in patients with diabetes, who are treated with ACE inhibitors and ARBs. Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2. ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.

More broadly, they're saying that many of the medical notes of patients who died mentioned that the patients also had diabetes or hypertension, and they're wondering if the correlation is about the treatment for those conditions and not about the conditions themselves.

It's not clear to me whether they're implying that anyone who takes ibuprofen (e.g. for a headache or even for a COVID-19 fever) will have more ACE2 and therefore be more susceptible to severe and fatal COVID-19, or if that effect only happens in the context of treatment for diabetes and hypertension. I can see how you can read it in the first way, but it feels like they would have titled it clearer if that were what they were actually saying.

In particular, there is plenty of advice for people with mild COVID-19 cases to do the normal things they'd do to take care of a flu at home, including take ibuprofen. If that's a bad idea, I feel like they would have said that more loudly.

(For instance - does it matter whether you've got more ACE2 if you're already infected and trying to keep the symptoms under control?)

EDIT: Thanks to 'FeteCommuniste in another comment for linking this Twitter thread https://twitter.com/angie_rasmussen/status/12389469379166822... which points out that this is an un-peer-reviewed hypothesis.

I'm not sure what you're trying to say here - are you claiming that all young people with severe cases of COVID-19 (including, for instance, 33-year-old Wenliang Li) took ibuprofen?

Or simply that there exists a small group of people such that all people in that group took ibuprofen, and there are also other young people with severe cases who did not?

Given that standard advice for young people (who are expected not to have severe cases) is to take fever-reducing medication like ibuprofen, I feel like we need a lot more information here before we can turn this correlation into causation.

https://www.sciencedaily.com/releases/2011/11/111101130200.h...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869589/

I also think that this is part of the mechanism that makes zinc effective against viruses as a catalyst.

Generally, I think that it's good to keep fevers down for non-lethal infections like the common cold, especially for children. Just beware that aspirin may cause Reye's syndrome in the young:

https://www.healthline.com/health/headache-reyes-syndrome

But for serious infections like Covid-19, maybe it would be better to maintain a relatively safe temperature of say 101-102 F (38-39 C)? I'm honestly curious to know what doctors think of this.