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===Drug related risks=== The following drugs may be used for some ME/CFS symptoms and are a possible concern * '''<span id="ibuprofen">[[Ibuprofen]]</span>''' - Ibuprofen drugs (Nurofen, Bruprofen, Advil, Midol, Motrin, Motrin) are anti-inflammatories commonly used for cold/flu symptoms and for ME/CFS. There have been some reports that ibuprofen taken for COVID-19 may prolong the illness and increase it's severity. Several countries including the UK and France now recommend that people with suspected or confirmed COVID-19 avoid ibuprofen and '''use paracetamol / acetaminophen''' (e.g., Tylenol) instead, although the evidence for this is relatively limited.<ref name="MEA16Mar20" /><ref name="Day20200317">{{Cite journal | last = Day | first = Michael | date = 2020-03-17 | title = Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists |url =https://www.bmj.com/content/368/bmj.m1086 | journal = BMJ|language=en | volume = 368|doi=10.1136/bmj.m1086|issn=1756-1833|pmid=32184201}}</ref><ref>{{Cite web | url = https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/ | title = Stay at home advice - Coronavirus (COVID-19) | last = National Health Service | first = | author-link = National Health Service | date = 2020-02-28 | website = nhs.uk|language=en|archive-url=|archive-date=|url-status= | access-date = 2020-03-23}}</ref> There is no suggestion that ibuprofen affects the risk of catching COVID-19. * '''[[Rituximab]]''' - The MS Society has stated that taking rituximab, which has been used in clinical trials for ME/CFS, may affect the risk of catching COVID-19.<ref name="Covid-19-MS">{{Cite web | url = https://www.mssociety.org.uk/about-ms/treatments-and-therapies/disease-modifying-therapies/covid-19-coronavirus-and-ms | title = COVID-19 coronavirus and MS | last = MS Society | first = | author-link = | date = | website = mssociety.org.uk|language=en|archive-url=|archive-date=|url-status= | access-date = 2020-03-23}}</ref><ref>{{Cite web | url = https://renal.org/wp-content/uploads/2020/03/BAPN-COVID-19-patient-info-for-HD.PD_.Immunosuppression-17March20.pdf | title=Coronavirus (SARS-CoV-2) and its associated illness (COVID-19) {{!}} Information and Guidance for Children on Haemodialysis, Peritoneal Dialysis and Immune suppression (including Renal Transplants) | last = Renal Association | first = | author-link = | date = 2020-03-17 | website = renal.org|archive-url=|archive-date=|url-status= | access-date = 2020-03-23}}</ref> * '''[[Ampligen]]''' - Ampligen or ''rintatolimod'' is sometimes used by ME/CFS patients, it is an [[antiviral]] immunostimulant rather than immunosuppressing drug, and is being tested for the treatment of COVID-19 illness in Japan.<ref>{{Cite web | url = https://adisinsight.springer.com/drugs/800001203 | title = Rintatolimod - AIM ImmunoTech - AdisInsight | website = adisinsight.springer.com | access-date = 2020-03-23}}</ref> There is no information about whether it may help prevent COVID-19 in ME/CFS patients. *'''[[Fludrocortisone]]''', a [[corticosteroid]] (steroid) - brand names include Florinef. This may be used by patients with [[Postural orthostatic tachycardia syndrome|POTS]], which is common in ME/CFS patients.<ref name="Fludrocortisone-Drugbank">https://www.drugbank.ca/drugs/DB00687</ref> * Other '''[[corticosteroid]]s''' (steroids) if they could suppress the immune system.<ref name="UKgov-vulnerable">{{Cite web | url = https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults | website = gov.uk | access-date = 2020-04-06 | title = COVID-19 guidance on social distancing and for vulnerable people | last = Public Health England}}</ref> * Any other '''immunosuppressant drugs or therapies''', including chemotherapy treatments and certain targeted cancer treatments<ref name="UKgov-vulnerable" /><ref name="UKgov-extremelyvulnerable">{{Cite web | title = Guidance on shielding and protecting extremely vulnerable people from COVID-19 | url = https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19 | website = gov.uk | access-date = 2020-04-06 | last = Public Health England}}</ref> {{Quote box|I have now reached the conclusion that people with pre-existing health conditions that make them more vulnerable to lung complications (which may or may not be the case with ME/CFS β at this stage we just donβt know), or have a condition like ME/CFS where an infection such as this will almost certainly cause a relapse, or significant exacerbation of symptoms, need to be doing far more to protect themselves, and to socially distance themselves from other people, than official NHS guidance indicates. In particular, for those who are not housebound, this applies to social mobility and what you can do (and cannot do) if you decide to leave your home.<ref name="MEA16Mar20"/> | author = [[Charles Shepherd]], ME Association | date = Mar 16, 2020 | title = Advice from the UK's ME Association}} ====<span id="deathrisk">Risk of death or serious complications in ME/CFS patients</span>==== {{Quote box|Although ME is a "chronic condition" my gut feeling is that they are not actually at greater risk of dying from the virus itself than healthy people. The conditions which put people at extra risk would be things like severe asthma or COPD, or immunosuppressed people eg those on chemotherapy for cancer. The biggest worry therefore for ME sufferers is that catching the virus will make their ME much worse, and of course people in the 25% group do not have much leeway. It might even be that worsening of their already severe ME could be a bigger threat to life than the virus itself.<ref name="SpeightMar20" /> | author = [[Nigel Speight]] | date = Mar 2020 | title = 25% ME Group for Severe ME}} ====<span id="triggerforME">Risk of developing ME/CFS after COVID-19</span>==== ME/CFS has been linked to many different viruses, but it is not known what the likelihood is of developing ME/CFS after COVID-19 illness. {{See also|Postviral fatigue syndrome}}
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