Active COVID-19, Clinical Pathway — All Settings

NSAIDS

Ibuprofen, NSAIDS	No current data connects the use of NSAIDS including ibuprofen to worsening COVID-19 symptoms. Not all fevers require antipyretics, but if an antipyretic is used, acetaminophen or ibuprofen are options. For patients on chronic NSAID therapy who wish to use an alternative, discuss this with the prescribing healthcare provider before any changes are made.

Ibuprofen, NSAIDS

No current data connects the use of NSAIDS including ibuprofen to worsening COVID-19 symptoms.
Not all fevers require antipyretics, but if an antipyretic is used, acetaminophen or ibuprofen are options.

For patients on chronic NSAID therapy who wish to use an alternative, discuss this with the prescribing healthcare provider before any changes are made.

ACE-I, ARB

ACE-I/ARB	The American College of Cardiology, the American Heart Association, and the Heart Failure Society of America have issued recommendations that ACE-I and ARB therapy should be continued in patients with COVID-19, particularly in patients with an increased risk of exacerbating underlying conditions upon discontinuation of therapy. A randomized controlled trial of hospitalized COVID-19 patients found no difference in clinical outcomes whether the ACE-I or ARB was continued or stopped at admission. Observational data has also demonstrated no difference in illness severity or mortality with continued use of ACE-I’s or ARB’s.

ACE-I/ARB

The American College of Cardiology, the American Heart Association, and the Heart Failure Society of America have issued recommendations that ACE-I and ARB therapy should be continued in patients with COVID-19, particularly in patients with an increased risk of exacerbating underlying conditions upon discontinuation of therapy. A randomized controlled trial of hospitalized COVID-19 patients found no difference in clinical outcomes whether the ACE-I or ARB was continued or stopped at admission. Observational data has also demonstrated no difference in illness severity or mortality with continued use of ACE-I’s or ARB’s.

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Active COVID-19, Clinical Pathway — All Settings

NSAIDS

ACE-I, ARB

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COVID Disease — NSAIDS, ACE-I, ARB — Clinical Pathway: All Settings

Active COVID-19, Clinical Pathway — All Settings

NSAIDS

ACE-I, ARB