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Some Medications May Increase COVID-19 Risk

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Certain medications could make you more susceptible to contracting COVID-19 and could worsen infection.

  • NSAIDs: You may have already heard that non-steroidal anti-inflammatory drugs (such as ibuprofen and aspirin used to reduce pain, fever, and inflammation) may aggravate coronavirus infection. Because these drugs may affect the immune response, they can potentially elongate the infection time and increase the possibility of complications. While some studies support this line of thinking, the evidence is minimal and more studies are needed. Experts agree that they know very little about how NSAIDs effect coronavirus infection and are looking further into the association. In the meantime, the recommendation is that patients should use acetaminophen (such as Tylenol) to reduce pain and fever. 
  • Corticosteroids: Because of their immunosuppressive characteristics, the routine use of corticosteroids is discouraged during the COVID-19 pandemic. These recommendations are in place because corticosteroids dampen the immune system, hypothetically increasing the risk of contracting the coronavirus, as well as prolonging infection and increasing the likelihood of complications. It’s important to point out that no conclusive studies exist linking corticosteroid use to an increased risk of coronavirus infection or complications, yet their immunosuppressive nature is a concern. More studies are needed to reach conclusive guidelines.
  • Antibiotics: Approximately 80% of your immune cells live in your gut; therefore, your immune health is intrinsically tied to your gut health. While antibiotics can be helpful in killing pathogenic bacteria, they also destroy beneficial gut bacteria that are essential for good immunity. At Gutbliss, we not only recommend avoiding antibiotics unless absolutely necessary on a normal day, but especially during these times when healthy gut bacteria are extremely important to your overall immunity.  
  • Biologics: This class of drugs (such as Humira and Remicade) is prescribed most often for autoimmune diseases. They inhibit the body’s immune response, keeping symptoms at bay. While these drugs can be helpful in managing autoimmunity, they also significantly suppress the immune system, making individuals who are taking them more susceptible to contracting infections. While there is no direct research linking biologic use and coronavirus infection, if you are being treated with a biologic, now is a good time to have a conversation with your health care practitioner about whether switching to a non-immunosuppressive therapy might be warranted.
  • PPIs: Studies have shown that long-term proton pump inhibitor (PPI) use can cause a host of health complications, including: increased risk of fractures, pneumonia, Clostridium difficile diarrhea, hypomagnesemia, vitamin B12 deficiency, chronic kidney disease, and even dementia. In addition, a 2019 study published in JAMA found that PPI use can increase the risk of contracting viral infections. If you are currently on a PPI, consider working with your healthcare provider to taper off your PPI and implement lifestyle modifications to manage your reflux. People with Barrett’s esophagus (a potentially pre-cancerous condition) may need to stay on their PPI, but the majority of people taking a PPI for acid reflux should be able to manage symptoms with diet and lifestyle modifications.

Takeaway: During this time of uncertainty, as scientists grapple with the incredible task of deepening the research available on COVID-19, it’s very important that you familiarize yourself with the medications you’re taking and how they impact your immunity. It’s equally important that you speak to your doctor and work closely with them to assess the risks and benefits of the medicines you’re taking. Remember, when it comes to the heath of your immune system, less is often more, in terms of medications and the effects they can have.

Robynne Chutkan, MD

Robynne Chutkan, MD, FASGE, is the founder of Gutbliss Rx. She is an integrative gastroenterologist and the bestselling author of Gutbliss, The Microbiome Solution, and The Bloat Cure. Educated at Yale and Columbia, she’s been on the faculty at Georgetown University Hospital since 1997 and is the founder of the Digestive Center for Wellness, an integrative gastroenterology practice incorporating microbiome analysis and nutritional counseling as part of the therapeutic approach to digestive disorders. An avid runner, snowboarder, and yogi, she is passionate about helping her patients live not just longer lives, but dirtier ones!

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