Therapeutic OpinionCOVID-19 and Avoiding Ibuprofen. How Good Is the Evidence?Kutti Sridharan, Gurusaravanan MD1,*; Kotagiri, Rajesh MD1; Chandiramani, Vijay H. MD1; Mohan, Babu P. MD1; Vegunta, Rathnamitreyee MD2; Vegunta, Radhakrishna MD3; Rokkam, Venkata R. P. MD1Author Information 1Department of Internal Medicine, Banner University Medical Center, University of Arizona, Tucson, AZ; 2Department of Internal Medicine, Westchester Medical Center, Valhalla, NY; 3Department of Oncology, Sanford Health/University of North Dakota School of Medicine and Health Sciences, Fargo, ND. *Address for correspondence: Clincal Assistant Professor of Medicine, Banner University Medical Center, University of Arizona, Tucson, AZ 85724. E-mail: [email protected] The authors have no conflicts of interest to declare. American Journal of Therapeutics: July/August 2020 - Volume 27 - Issue 4 - p e400-e402 doi: 10.1097/MJT.0000000000001196 Buy Metrics Abstract Ibuprofen is an over-the-counter medication that is used widely for the treatment of pain and fever during COVID-19 pandemic. A concern was raised regarding the safety of ibuprofen use because of its role in increasing ACE2 levels within the Renin–Angiotensin–Aldosterone system. ACE2 is the coreceptor for the entry of SARS-CoV-2 into cells, and so, a potential increased risk of contracting COVID-19 disease and/or worsening of COVID-19 infection was feared with ibuprofen use. However, available data from limited studies show administration of recombinant ACE2 improves lung damage caused by respiratory viruses, suggesting ibuprofen use may be beneficial in COVID-19 disease. At this time, there is no supporting evidence to discourage the use of ibuprofen. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.