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

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

#21

Post by himinlomax »

neuronic wrote: post #16
throwawayy477 wrote: post #14

Earlier quoted context omitted.

Ibuprofen is an anti-inflammation drug, which means it weakens somewhat your immune system (which is responsible for the inflammation in the first place). It makes sort of sense that taking such medication while infected with a virus for which there is no treatment can be dangerous. In related news, there have been cases of "severe" forms of Covid-19 among young people with no antecedents, all of them having taken ib…

Why are you putting severe in quotation marks? What makes you feel qualified to give medical advice on an Internet forum? There might be negatives to taking ibuprofen in relation to COVID-19, but so far no official guidelines exist. Only internet stories. Responsible institutes have not handed out such advice, nowhere.

It's already considered unsafe to take NSAIDs when suffering from influenza. In fact it's even been hypothesized that the Spanish flu pandemic was so bad because of widespread use of (the new) aspirin.

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

#22

Post by takeda »

jbattle wrote: post #11

After a couple of asthmatic attacks after taking aspirin and ibuprofen I went to an allergist and she told me that I have an allergic reaction to all NSAIDs. 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...

Sadly NERD doesn't refer to you, but to the disease ;P

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

#23

Post by throwawayy477 »

geofft wrote: post #17
throwawayy477 wrote: post #14

Earlier quoted context omitted.

Ibuprofen is an anti-inflammation drug, which means it weakens somewhat your immune system (which is responsible for the inflammation in the first place). It makes sort of sense that taking such medication while infected with a virus for which there is no treatment can be dangerous. In related news, there have been cases of "severe" forms of Covid-19 among young people with no antecedents, all of them having taken ib…

> In related news, there have been cases of "severe" forms of Covid-19 among young people with no antecedents, all of them having taken ibuprofen. 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…

I don't know what happened to Wenliang Li. What I know is that there have been reports of severe cases among young people without antecedents or pre-existing pathologies where I live and the common thread was that they took ibuprofen. In parallel, there are papers/preprints popping left and right suggesting that ibuprofen's side effects may worsen the symptoms of covid-19. Just google things, it's not hard to find.

>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.

There's other fever-reducing medication that doesn't involve anti-inflammation action. Paracetamol is fine.

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

#24

Post by zozbot234 »

takeda wrote: post #13
mlrtime wrote: post #4

https://www.theguardian.com/world/2020/mar/14/anti-inflammat...

Was about to say this. 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.

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

It seems to be both. Plausibly at least, CRS may be often involved in damage to the respiratory system, but COVID-19 is not unlike SARS in that severe forms can directly attack other parts of the body. So any treatment based on lowering inflammation or any other part of the immune response will have to be carefully tuned.

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

#25

Post by sbuttgereit »

throwawayy477 wrote: post #14
dmurray wrote: post #5

Ibuprofen, along with paracetamol, is generally considered very safe. All over the world they are prescribed for any kind of pain, fever, inflammation or discomfort. Of course, there are some known side effects, but they are generally considered minor. Does it make sense that a virus would evolve to favour these conditions? Or is it just an unfortunate coincidence? I guess it depends on whether the virus being "worse…

Ibuprofen is an anti-inflammation drug, which means it weakens somewhat your immune system (which is responsible for the inflammation in the first place). It makes sort of sense that taking such medication while infected with a virus for which there is no treatment can be dangerous. In related news, there have been cases of "severe" forms of Covid-19 among young people with no antecedents, all of them having taken ib…

This is precisely the sort of comment that not only makes social networking a medium with nearly no real value, but actually dangerous.

The commentator comes here with some assumptions, perhaps some hearsay, and an emotional attachment to their position and make the statement as though it's fact.

In this comment, you know what's missing? Actual knowledge, actual reasoning, and actual facts to back up the his/her claims. Perhaps worse, there are some facts (Ibuprofen suppresses some immune system responses to infection) which are used to draw unsubstantiated conclusions about the commentator's opinions (Ibuprofen can cause severe forms of Covid-19 in young people).

From where did this "related news" come from? On what rational basis do you draw the conclusion that an across-the-board recommendation not to take Ibuprofen is warranted? How does that trump other factors that may be at play?

What I really worry about though is how many people will read the comment I'm responding to and go on to post elsewhere, "in related news...", with a similar air of self-certainly and casting of opinions as facts. In other contexts of high emotion, people get lynched because of this sort of social media posting, people may cause themselves harm because of this kind of posting.

By the way, the commentator may actually be right... but there is nothing in the comment to make me believe that his/her being right would be anything more than coincidence.

I'll leave with the personal observation that this community is suppose to be made up of "the smart ones"; which we ourselves so often confidently believe to be true that we all too frequently think we should be able to engineer society and solve all its ills. If there is any one ponder-able to take away from reading Hacker News on regular basis, it's how decidedly average even "the smart ones" can be on any given topic.

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

#26

Post by neuronic »

throwawayy477 wrote: post #20
neuronic wrote: post #16

Earlier quoted context omitted.

Why are you putting severe in quotation marks? What makes you feel qualified to give medical advice on an Internet forum? There might be negatives to taking ibuprofen in relation to COVID-19, but so far no official guidelines exist. Only internet stories. Responsible institutes have not handed out such advice, nowhere.

> Why are you putting severe in quotation marks? Because I don't know the official terminology. >What makes you feel qualified to give medical advice on an Internet forum? Because of where I work I have been given "primary sources", but of course you are free to not believe me. This is my own sentiment, feel free to look things up yourself. > no official guidelines exist. Only internet stories. Not in the US, maybe,…

If any official source, regardless of country, recommends to abstain from ibuprofen I would simply like to know. I neither live in the US nor think that scientists and medical personnel in other country are less educated or trained.

I think it's about distinguishing important information from stuff people randomly write online because a non-peer reviewed study made a hypothesis.

The goal is for everyone around the globe to be as safe as possible and misinformation in the context of medical advice is not helpful.

Of course it's better not to take ibuprofen, in any case. But some people may rely on it or other NSAIDs.

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

#27

Post by he0001 »

geofft wrote: post #18
happycube wrote: post #12

Bettridge's law may be wrong here... sounds like the answer is "maybe"

But this isn't even the real headline. The real headline is "Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?" And it's not even a headline, it's a title of a medical note to other researchers to advance a hypothesis. This isn't a news source, this is work in progress in the early stages of the scientific method.

How do you follow up one these “articles”. I understand that it is a hypothesis, but unfortunately these articles do create some nasty rumors, where these tend to be treated as facts instead of just a hypothesis.

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

#28

Post by throwanem »

dmurray wrote: post #5

Ibuprofen, along with paracetamol, is generally considered very safe. All over the world they are prescribed for any kind of pain, fever, inflammation or discomfort. Of course, there are some known side effects, but they are generally considered minor. Does it make sense that a virus would evolve to favour these conditions? Or is it just an unfortunate coincidence? I guess it depends on whether the virus being "worse…

Paracetamol (acetaminophen) isn't all that safe. Too high a dose can quickly and irreversibly damage your liver. Many people have died this way.

If you're intending to take paracetamol long term, you can do worse than to reduce the stated maximum daily dose on the bottle by 1/4 or 1/2. You'll be less comfortable, sure. But it's called a "liver" because you need one to live. So it's worth a little extra discomfort to avoid the risk of breaking yours.

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

#29

Post by fhars »

zackmorris wrote: post #19

I'm wondering if some of the downside of anti-inflammatories is that they often lower fevers. A fever is the body's natural response to infection, to raise the rate of chemical reactions and make more immune cells: 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 virus…

That is probably completely dependent on the infection you are treating. Sometimes it may be better to reduce stress on the patient, sometimes higher temperatures help stop the infection. After all, someone got a Nobel prize for infecting people with malaria to cure them of syphilis https://en.m.wikipedia.org/wiki/Pyrotherapy

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

#30

Post by zamalek »

dmurray wrote: post #5

Ibuprofen, along with paracetamol, is generally considered very safe. All over the world they are prescribed for any kind of pain, fever, inflammation or discomfort. Of course, there are some known side effects, but they are generally considered minor. Does it make sense that a virus would evolve to favour these conditions? Or is it just an unfortunate coincidence? I guess it depends on whether the virus being "worse…

> Does it make sense that a virus would evolve to favour these conditions?

I strongly doubt that COVID-19 has been exposed to NSAIDs long enough to result in evolution of any type. The paper suggests that NSAIDs make us more biocompatible, so it really is just a coincidence. Lots of medications have contra-indications.

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