Anti-inflammatory drugs might not actually make COVID-19 worse

NSAIDs like ibuprofen are used throughout the world to treat fever and pain. Physicians cast doubt that they influence our immune response to the coronavirus.

On Saturday, the French health minister, Olivier Véran, tweeted that taking anti-inflammatory drugs—even over-the-counter medications like ibuprofen, Advil, and Aleve—could worsen cases of COVID-19. “If you are already taking anti-inflammatory drugs or you have questions, ask your doctor for advice,” he tweeted in French. This advice, which was not backed by any peer-reviewed scientific paper or any other release of evidence, is raising eyebrows in the public health world.

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Italy weeks into COVID-19 epidemic
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Italy weeks into COVID-19 epidemic
Medical workers in overalls stretch a patient under intensive care into the newly built Columbus Covid 2 temporary hospital to fight the new coronavirus infection, on March 16, 2020 at the Gemelli hospital in Rome. (Photo by ANDREAS SOLARO / AFP) (Photo by ANDREAS SOLARO/AFP via Getty Images)
MOLINETTE HOSPITAL, TURIN, ITALY - 2020/03/16: A banner reading 'Thanks for what you are doing' hangs outside emergency room of hospital Molinette to thank doctors, nurses and others medical workers. The Italian government imposed unprecedented restrictions to halt the spread of COVID-19 coronavirus outbreak, among other measures people movements are allowed only for work, for buying essential goods and for health reasons. (Photo by Nicolò Campo/LightRocket via Getty Images)
MOLINETTE HOSPITAL, TURIN, ITALY - 2020/03/16: A nurse measures temperature of a man for pre triage, to carry out coronavirus infection control tests. The Italian government imposed unprecedented restrictions to halt the spread of COVID-19 coronavirus outbreak, among other measures people movements are allowed only for work, for buying essential goods and for health reasons. (Photo by Nicolò Campo/LightRocket via Getty Images)
CORIGLIANO-ROSSANO, CALABRIA, ITALY - 2020/03/16: People keeping a safe distance queuing outside a post office wearing a mask for fear of Coronavirus infection (COVID-19). (Photo by Alfonso Di Vincenzo/KONTROLAB/LightRocket via Getty Images)
A medical worker wearing a face mask and overalls drives an ambulance into the newly built Columbus Covid 2 temporary hospital to fight the new coronavirus infection, on March 16, 2020 at the Gemelli hospital in Rome. (Photo by ANDREAS SOLARO / AFP) (Photo by ANDREAS SOLARO/AFP via Getty Images)
A woman walks her dogs across the deserted surroundings of the closed Colosseum monument on March 16, 2020 in Rome. (Photo by Filippo MONTEFORTE / AFP) (Photo by FILIPPO MONTEFORTE/AFP via Getty Images)
Medical workers in overalls stretch a patient under intensive care into the newly built Columbus Covid 2 temporary hospital to fight the new coronavirus infection, on March 16, 2020 at the Gemelli hospital in Rome. (Photo by ANDREAS SOLARO / AFP) (Photo by ANDREAS SOLARO/AFP via Getty Images)
A mural by artist Franco Rivolli Art, depicting a nurse wearing a face mask, with wings behind her back and cradling Italy, is pictured on a wall of the Papa Giovanni XXIII Hospital in Bergamo, Lombardy, on March 16, 2020. (Photo by Piero Cruciatti / AFP) / RESTRICTED TO EDITORIAL USE - MANDATORY MENTION OF THE ARTIST UPON PUBLICATION - TO ILLUSTRATE THE EVENT AS SPECIFIED IN THE CAPTION (Photo by PIERO CRUCIATTI/AFP via Getty Images)
NAPLES, CAMPANIA, ITALY - 2020/03/16: (EDITORS NOTE: Image was created with a drone.) View of the empty Dante Alighieri square in Naples city, after the Italian government has imposed unprecedented national restrictions on controlling the coronavirus COVID 19. (Photo by Salvatore Laporta/KONTROLAB/LightRocket via Getty Images)
A hearse transporting a coffin enters the Monumental cemetery of Bergamo, Lombardy, as relatives of a deceased person walk outside on March 16, 2020, while burials of people who died of the new coronavirus are being conducted at the rythm of one every half hour. (Photo by Piero Cruciatti / AFP) (Photo by PIERO CRUCIATTI/AFP via Getty Images)
Medical workers in overalls stretch a patient under intensive care into the newly built Columbus Covid 2 temporary hospital to fight the new coronavirus infection, on March 16, 2020 at the Gemelli hospital in Rome. (Photo by ANDREAS SOLARO / AFP) (Photo by ANDREAS SOLARO/AFP via Getty Images)
Residents on window and balconies sing 'Il cielo sempre piu blu' (The sky becomes more and more blue) during a flash mob to raise morale as the lock down continues due to the coronavirus outbreak to the Garbatella neighbourhood on March 16, 2020, in Rome, Italy. The Italian Government has taken the unprecedented measure of a nationwide lockdown by closing all businesses except essential services such as, pharmacies, grocery stores, hardware stores and tobacconists and banks, in an effort to fight the world's second-most deadly coronavirus (COVID-19) outbreak outside of China. The movements in and out are allowed only for work and health reasons proven by a medical certificate. The number of confirmed cases of the Coronavirus COVID-19 disease in Italy has jumped up to at least 27.980 while the death toll have reached 2158. (Photo by Andrea Ronchini/NurPhoto via Getty Images)
Residents on window and balconies sing 'Il cielo sempre piu blu' (The sky becomes more and more blue) during a flash mob to raise morale as the lock down continues due to the coronavirus outbreak to the Garbatella neighbourhood on March 16, 2020, in Rome, Italy. The Italian Government has taken the unprecedented measure of a nationwide lockdown by closing all businesses except essential services such as, pharmacies, grocery stores, hardware stores and tobacconists and banks, in an effort to fight the world's second-most deadly coronavirus (COVID-19) outbreak outside of China. The movements in and out are allowed only for work and health reasons proven by a medical certificate. The number of confirmed cases of the Coronavirus COVID-19 disease in Italy has jumped up to at least 27.980 while the death toll have reached 2158. (Photo by Andrea Ronchini/NurPhoto via Getty Images)
Residents on window and balconies sing 'Il cielo sempre piu blu' (The sky becomes more and more blue) during a flash mob to raise morale as the lock down continues due to the coronavirus outbreak to the Garbatella neighbourhood on March 16, 2020, in Rome, Italy. The Italian Government has taken the unprecedented measure of a nationwide lockdown by closing all businesses except essential services such as, pharmacies, grocery stores, hardware stores and tobacconists and banks, in an effort to fight the world's second-most deadly coronavirus (COVID-19) outbreak outside of China. The movements in and out are allowed only for work and health reasons proven by a medical certificate. The number of confirmed cases of the Coronavirus COVID-19 disease in Italy has jumped up to at least 27.980 while the death toll have reached 2158. (Photo by Andrea Ronchini/NurPhoto via Getty Images)
A medical worker in overalls exits an ambulance outside the newly built Columbus Covid 2 temporary hospital to fight the new coronavirus infection, on March 16, 2020 at the Gemelli hospital in Rome. (Photo by ANDREAS SOLARO / AFP) (Photo by ANDREAS SOLARO/AFP via Getty Images)
ROME, ITALY - MARCH 16: Giulia Baini, 24, a volunteer from the Community of Sant'Egidio, speaks to Giovanna, a frail elderly woman of 82 years of age during a home-care service on March 16, 2020 in Rome, Italy. The Italian Government has taken the unprecedented measure of a nationwide lockdown by closing all businesses except essential services such as, pharmacies, grocery stores, hardware stores, tobacconists and banks, in an effort to fight the world's second-most deadly Coronavirus (COVID-19) outbreak outside of China. Journeys are allowed only for work reasons and health reasons proven by a medical certificate. Citizens are encourage to stay home and have an obligation to respect a safety distance of one metre from each other in supermarkets or in public spaces. (Photo by Marco Di Lauro/Getty Images)
SALERNO, ITALY - MARCH 16: A nurse inside a Civil Protection tent set up as a Pre-Triage in the Luigi Curto hospital on March 16, 2020 in Polla, Italy. Italian Government continues to enfoce the nationwide lockdown measures to control the coronavirus spread. The number of people infected with coronavirus in Italy is growing, new cases are reported in many southern regions. In the Campania Region, the local government has decided to quarantine five Municipalities so that preventing anyone from entering or leaving Ariano Irpino in the province of Avellino, Atena Lucana, Caggiano, Polla and Sala Consilina in the province of Salerno. (Photo by Ivan Romano/Getty Images)
SALERNO, ITALY - MARCH 16: A nurse inside a Civil Protection tent set up as a Pre-Triage in the Luigi Curto hospital on March 16, 2020 in Polla, Italy. Italian Government continues to enfoce the nationwide lockdown measures to control the coronavirus spread. The number of people infected with coronavirus in Italy is growing, new cases are reported in many southern regions. In the Campania Region, the local government has decided to quarantine five Municipalities so that preventing anyone from entering or leaving Ariano Irpino in the province of Avellino, Atena Lucana, Caggiano, Polla and Sala Consilina in the province of Salerno. (Photo by Ivan Romano/Getty Images)
A man runs across a deserted Lungotevere Marzio embankment on March 16, 2020 in Rome. (Photo by Vincenzo PINTO / AFP) (Photo by VINCENZO PINTO/AFP via Getty Images)
SALERNO, ITALY - MARCH 16: The interior of a Civil Protection tent set up as a Pre-Triage of the Luigi Curto hospital on March 16, 2020 in Polla, Italy. Italian Government continues to enfoce the nationwide lockdown measures to control the coronavirus spread. The number of people infected with coronavirus in Italy is growing, new cases are reported in many southern regions. In the Campania Region, the local government has decided to quarantine five Municipalities so that preventing anyone from entering or leaving Ariano Irpino in the province of Avellino, Atena Lucana, Caggiano, Polla and Sala Consilina in the province of Salerno. (Photo by Ivan Romano/Getty Images)
People wearing a face mask walk across the Gianicolo promenade on March 16, 2020 in Rome. (Photo by Vincenzo PINTO / AFP) (Photo by VINCENZO PINTO/AFP via Getty Images)
Empty check-in counters are seen at a terminal of the airport of Naples, Italy, on March 16, 2020 where air traffic slowed down due to the spread of the novel coronavirus. (Photo by Paolo Manzo/NurPhoto via Getty Images)
TOPSHOT - A patient (L) flashes the victory sign as she is being brought into the newly built Columbus Covid 2 temporary hospital to fight the new coronavirus infection, on March 16, 2020 at the Gemelli hospital in Rome. (Photo by ANDREAS SOLARO / AFP) (Photo by ANDREAS SOLARO/AFP via Getty Images)
A woman takes a picture of a notice informing customers of the temporary closure over coronavirus concerns of the Disney store on Oxford Street in London, England, on March 16, 2020. Around the country, as elsewhere in the world, covid-19 coronavirus fears continue to escalate as the numbers of cases and deaths continues to rise. British Prime Minister Boris Johnson meanwhile remains under pressure over the government's so-called herd immunity strategy, which bucks the closures-and-lockdowns approach adopted by countries such as Italy and Spain. (Photo by David Cliff/NurPhoto via Getty Images)
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The class of drugs that Veran was calling out were, specifically, non-steroidal anti-inflammatories (NSAIDs), which are already more closely regulated in France than in most other countries, including the United States.

NSAIDs like ibuprofen are used throughout the world to treat fever and pain.The Guardian reports that a spokesperson from Toulouse hospital in France explained that anti-inflammatories can increase the risk of complications “when there is a fever or infection.” And the French ministry of health website reports “severe adverse events related to the use of... NSAIDs… in patients with COVID-19, possible or confirmed cases.”

Elsewhere in the world, however, health authorities are casting doubt on this stance for COVID-19 specifically. “I have no data to support this. I don’t know where he’s coming from,” says Carlos Del Rio, a physician and professor of public health and medicine at Emory University who is on the front lines of COVID-19 response.

Before he would be willing to consider the minister’s statement, Del Rio says, “I need to see a paper that shows that. It’s a pretty strong statement.” Some studies suggest that NSAIDS could impede a person’s immune response, but the degree to which that would influence the outcomes of people with COVID-19 hasn’t been studied or identified by any official studies or statements.

Muge Cevik, an infectious disease researcher at the University of St. Andrews in Scotland, echoed this concern on Twitter. “If French clinicians are observing a signal this should be communicated appropriately within a context,” she tweeted. “We need proper risk communication here.”

Statements like Véran’s draw attention from where it’s most needed, Del Rio says. “We need to shut down the country, and people need to take [social distancing] seriously. We’re not.” As for NSAIDs, he says, “show us the evidence. I would love to see the evidence.”

Meanwhile, the pandemic is unfolding. A new paper out today in Science suggests that people without symptoms are responsible for a significant portion of COVID-19’s spread. The CDC also released a new guideline suggesting cancelling all events with 50 people are more. Canada also just implemented travel bans aimed at slowing the spread of the disease.

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Figures who have tested positive for coronavirus
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Figures who have tested positive for coronavirus

Last week, Tom Hanks and Rita Wilson announced that they had tested positive for COVID-19 after contracting it in Australia, where Hanks was filming a movie. 

"We felt a bit tired, like we had colds, and some body aches," the Oscar-winning actor shared on Instagram. "Rita had some chills that came and went. Slight fevers too. To play things right, as is needed in the world right now, we were tested for the Coronavirus, and were found to be positive."

"Well, now. What to do next? The Medical Officials have protocols that must be followed. We Hanks’ will be tested observed, and isolated for as long as public health and safety requires. Not much more to it than a one-day-at-a-time approach, no?"

Idris Elba took to Twitter on Monday morning to announce that he, too, contracted the virus. The actor was at the same conference in Webley as Sophie Trudeau, who also tested positive. 

He shared with his fans:

"This morning I tested positive for Covid 19. I feel ok, I have no symptoms so far but have been isolated since I found out about my possible exposure to the virus. Stay home people and be pragmatic. I will keep you updated on how I’m doing. No panic.

Sophie Gregorie Trudeau, the wife of Canadian prime minister Justin Trudeau, was announced to have tested positive for the virus last week. 

Her symptoms developed after attending a conference in Britain in early March. The prime minister is not showing symptoms and will not be tested, but will remain under quarantine.

Kristofer Hivju, best known for his role as Tormund on "Game of Thrones," took to Instagram on Monday to reveal he was self quarantining with his family in Norway.  

"We are in good health,” he wrote. “I only have mild symptoms of a cold. There are people at higher risk for who this virus might be a devastating diagnosis, so I urge all of you to be extremely careful; wash your hands, keep 1,5 meters distance from others, go in quarantine; just do everything you can to stop the virus from spreading.

Olga Kurylenko, who starred in the James Bond movie “Quantum of Solace,” announced this weekend that she has contracted COVID-19, the disease caused by the new coronavirus. 

“I’ve actually been ill for almost a week now,” she wrote on Instagram. “Fever and fatigue are my main symptoms. Take care of yourself and do take this seriously!”

Donavan Mitchell and Rudy Gobert, both players on the Utah Jazz basketball team, have tested positive for the virus. Gobert was the first NBA player to test positive, which prompted the suspension of the rest of the basketball season. 
Callum Hudson-Odoi, a forward for the Chelsea football team, tested positive for the virus, in addition to Arsenal coach Mikel Arteta. Following the announcement, all professional soccer games in England have been postponed. 
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