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Do anti-inflammatories aggravate coronavirus infection? That's a valid concern, and one that the World Health Organization is looking in to. But no formal recommendation has yet been made.

The concern originated in a correspondence published on March 13, 2020, in the journal The Lancet Respiratory Medicine and was noted by France's minister of health Olivier Véran in a tweet (archived here) which read:

⚠️ #COVIDー19 | La prise d'anti-inflammatoires (ibuprofène, cortisone, ...) pourrait être un facteur d'aggravation de l'infection. En cas de fièvre, prenez du paracétamol. Si vous êtes déjà sous anti-inflammatoires ou en cas de doute, demandez conseil à votre médecin.

Translation:

#COVID-19 | Taking anti-inflammatory drugs (ibuprofen, cortisone, ...) could be an aggravating factor of the infection. If you have a fever, take paracetamol. If you are already on anti-inflammatory drugs or in doubt, ask your doctor for advice."

Users on social media saw this:

⚠️ #COVIDー19 | La prise d'anti-inflammatoires (ibuprofène, cortisone, ...) pourrait être un facteur d'aggravation de l'infection. En cas de fièvre, prenez du paracétamol.
Si vous êtes déjà sous anti-inflammatoires ou en cas de doute, demandez conseil à votre médecin.

-- Olivier Véran (@olivierveran) March 14, 2020

While there may be no known cure for coronavirus, people may boost their chances of surviving it by steering clear of anti-inflammatories, according to Dr. Olivier Veran, the health minister of France who is also a medical doctor.

The Guardian newspaper wrote about the tweet. Moreover, the concerns about a possible link between COVID-19 and anti-inflammatories appear to have been cited first in a letter published on March 11, 2020, in the journal The Lancet Respiratory Medicine.

The authors looked at three studies of patients with COVID-19 in China and the underlying illnesses of those who died.

Prof. Michael Roth, head of pulmonary cell research at the University of Basel, noted in the correspondence that nearly two-thirds - 65% - of the patients who died had been diagnosed with high blood pressure, diabetes or cardiovascular disease. He wrote:

Notably, the most frequent comorbidities in these three studies of patients with COVID-19 are often treated with angiotensin-converting enzyme (ACE) inhibitors."

ACE inhibitors are prescribed to lower blood pressure; they also exert an anti-inflammatory effect.

"We therefore hypothesized that drugs that up-regulate the virus binding protein ACE2 [an enzyme that lowers blood pressure by relaxing veins and arteries and also helps cells regenerate] might increase the risk of severe COVID-19," Roth said in an email to Lead Stories. "The drugs with such an action include ACE-inhibitors, angiotensin receptor blockers and ibuprofen," also known as Motrin and Advil.

He added in the email:

The HYPOTHESIS is based on studies from the SARS 2002-3 epidemic and on subsequent studies in animals, not so in men."

The SARS epidemic, which resulted in more than 8,000 cases in 26 countries, was caused by a coronavirus, according to the World Health Organization (WHO).

In his email, Roth said that the link between hypertension, diabetes, cardiovascular diseases and severe/fatal COVID-19 has been confirmed in additional studies from China.

He noted that he and his fellow authors had said in their communication to the journal that "changes of the medication for the severe patients should be reconsidered."

A spokesman for WHO said in an email that the organization is aware of the concerns and is gathering further evidence on this issue before making a formal recommendation:

WHO is aware of concerns on the use of non-steroidal anti-inflammatory drugs (i.e., ibuprofen) for the treatment of fever for people with COVID-19. WHO is gathering further evidence on this issue before making a formal recommendation, but after a rapid review of the literature, is not aware of published clinical or population-based data on this topic."