Abstract
Inhaled corticosteroids (ICS) could increase both the risk of coronavirus disease 2019 (COVID-19) and experiencing poor outcomes. To compare the clinical outcomes between ICS users and nonusers, COVID-19-related claims in the Korean Health Insurance Review and Assessment database were evaluated. To evaluate susceptibility to COVID-19 among patients with COPD or asthma, a nested case-control study was performed using the same database. In total, 7341 patients were confirmed to have COVID-19, including 114 ICS users and 7227 nonusers. Among 5910 patients who were hospitalized, death was observed for 9% of ICS users and 4% of nonusers. However, this association was not significant when adjusted for age, sex, region, comorbidities, and hospital type (aOR, 0.94; 95% CI, 0.43–2.07). The case-control analysis of COPD compared 640 cases with COVID-19 to 2560 matched controls without COVID-19, and the analysis of asthma compared 90 cases with COVID-19 to 360 matched controls without COVID-19. Use of ICS was not significantly associated with COVID-19 among patients with COPD (aOR, 1.02; 95% CI, 0.46–2.25) or asthma (aOR, 0.38; 95% CI, 0.13–1.17). Prior ICS use was not significantly associated with COVID-19 in patients with COPD or asthma, nor with clinical outcomes among patients with COVID-19.
Highlights
The current coronavirus disease 2019 (COVID-19) pandemic is caused by a novel coronavirus [1]
Previous studies have indicated that there is no benefit in using systemic corticosteroids to treat SARS [5], and there are concerns regarding the use of Inhaled corticosteroids (ICS) in COVID-19 cases, given the possibility of immunosuppression caused by long-term ICS treatment
In-hospital treatments were more common among ICS users, these findings were not observed in the subgroups of patients with chronic obstructive pulmonary disease (COPD) or asthma (Table S6)
Summary
The current coronavirus disease 2019 (COVID-19) pandemic is caused by a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) [1]. There are limited clinical data regarding the potential benefits or harms associated with the use of ICS and other drugs for respiratory diseases among individuals who are at risk of contracting the SARS-CoV-2 infection or patients who have COVID-19. There was no potential control group of individuals who did not have COVID-19, which precludes a conclusion regarding the association between ICS use and the risk of COVID-19. We performed this epidemiological study aiming to evaluate the potential benefits and harms associated with the use of ICS or other drugs for respiratory diseases among a large sample of individuals with and without COVID-19 who had detailed information regarding comorbidities and prior medication exposures
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