The
coronavirus disease 19 (COVID-19) pandemic is currently the most acute healthcare challenge in the world. Despite growing knowledge of the nature of
Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2), treatment options are still poorly defined. The safety of non-steroidal anti-inflammatory drugs (
NSAIDs), specifically
ibuprofen, has been openly questioned without any supporting evidence or clarity over dose, duration, or temporality of administration. This has been further conflicted by the initiation of studies to assess the efficacy of
ibuprofen in improving outcomes in severe
COVID-19 patients. To clarify the scientific reality, a literature search was conducted alongside considerations of the pharmacological properties of
ibuprofen in order to construct this narrative review. The literature suggests that double-blind, placebo-controlled study results must be reported and carefully analysed for safety and efficacy in patients with
COVID-19 before any recommendations can be made regarding the use of
ibuprofen in such patients. Limited studies have suggested: (i) no direct interactions between
ibuprofen and SARS-CoV-2 and (ii) there is no evidence to suggest
ibuprofen affects the regulation of
angiotensin-converting-enzyme 2 (ACE2), the receptor for
COVID-19, in human studies. Furthermore, in vitro studies suggest
ibuprofen may facilitate cleavage of ACE2 from the membrane, preventing membrane-dependent viral entry into the cell, the clinical significance of which is uncertain. Additionally, in vitro evidence suggests that inhibition of the
transcription factor nuclear factor-κB (
NF-kB) by
ibuprofen may have a role in reducing excess
inflammation or
cytokine release in
COVID-19 patients. Finally, there is no evidence that
ibuprofen will aggravate or increase the chance of
infection of
COVID-19.