Pharmacoepidemiol Drug Saf. 2021 Aug 14. doi: 10.1002/pds.5345. Online ahead of print.
ABSTRACT
BACKGROUND: Recent evidence has established a beneficial effect of systemic corticosteroids for treatment of moderate-to-severe COVID-19.
OBJECTIVE: To determine if inhaled corticosteroid use is associated with COVID-19 outcomes.
METHODS: In a nationwide cohort of hospitalized SARS-CoV-2 test-positive individuals in Denmark, we estimated the 30-day hazard ratio of intensive care unit (ICU) admission or death among users of inhaled corticosteroids (ICS) compared with users of bronchodilators (β2 -agonist/muscarinic-antagonists), and non-users of ICS overall, with Cox regression adjusted for age, sex, and other confounders. We repeated these analyses among influenza test-positive patients during 2010-2018.
RESULTS: Among 6,267 hospitalized SARS-CoV-2 patients, 614 (9.8 %) were admitted to ICU and 677 (10.8 %) died within 30 days. ICS use was associated with a hazard ratio of 1.09 (95% CI [CI], 0.67 to 1.79) for ICU admission and 0.78 (95% CI, 0.56 to 1.11) for death compared with bronchodilator use. Compared with no ICS use overall, the hazard ratio of ICU admission or death was 1.17 (95% CI, 0.87 to 1.59) and 1.02 (95% CI, 0.78 to 1.32), respectively. Among 10,279 hospitalized influenza patients, of which 951 (9.2%) were admitted to ICU and 1,275 (12.4%) died, the hazard ratios were 1.43 (95% CI, 0.89 to 2.30) and 1.11 (95% CI, 0.85 to 1.46) for ICU admission, and 0.80 (95% CI, 0.63 to 1.01) and 1.03 (95% CI, 0.87 to 1.22) for death compared with bronchodilator use and no ICS use overall, respectively.
CONCLUSION: Our results do not support an effect of inhaled corticosteroid use on COVID-19 outcomes, however we can only rule out moderate-to-large reduced or increased risks.
PMID:34390285 | DOI:10.1002/pds.5345