Assessing the impact of long-term inhaled corticosteroid therapy on patients with COVID-19 and coexisting chronic lung disease: A multicenter retrospective cohort study

Author:

Pina Belmonte Adela1,Madrazo Manuel1,Piles Laura1,Rubio-Rivas Manuel2,de Jorge Huerta Lucía3,Gómez Antúnez María4,López Caleya Juan Francisco5,Arnalich Fernández Francisco6,Gericó-Aseguinolaza Martin7,Pesqueira Fontan Paula Maria8,Rhyman Nicolás9,Prieto Dehesa Marina10,Romero Cabrera Juan Luis11,García García Gema María12,García-Casasola Gonzalo13,Labirua-Iturburu Ruiz Ane14,Carrasco-Sánchez Francisco Javier15,Martínez Hernández Sara16,Pascual Pérez Maria de los Reyes17,López Castro José18,Serrano Carrillo de Albornoz José Luis19,Varona José F.20,Gómez-Huelgas Ricardo21,Antón-Santos Juan-Miguel13,Lumbreras-Bermejo Carlos3

Affiliation:

1. Hospital Universitario Doctor Peset

2. Bellvitge University Hospital

3. Hospital Universitario 12 De Octubre

4. Hospital General Universitario Gregorio Marañón

5. Hospital de Cabueñes

6. Hospital Universitario La Paz

7. Hospital Royo Villanova

8. Hospital Clinico de Santiago de Compostela

9. Hospital de Sant Joan Despí Moisès Broggi

10. Hospital Universitario Río Hortega

11. Hospital Universitario Reina Sofía

12. Hospital Universitario de Badajoz

13. Hospital Universitario Infanta Cristina

14. Hospital Santa Marina

15. Hospital Juan Ramón Jiménez

16. Hospital San Pedro

17. Hospital General Universitario de Elda

18. Hospital Público de Monforte de Lemos

19. Hospital de Poniente

20. Hospital Universitario Montepríncipe

21. Biomedical Research Institute of Málaga (IBIMA)

Abstract

Background Patients with chronic lung disease (CLD), such as asthma or chronic obstructive pulmonary disease, were expected to have an increased risk of clinical manifestations and severity of COVID-19. However, these comorbidities have been reported less frequently than expected. Chronic treatment with inhaled corticosteroids (ICS) may impact the clinical course of COVID-19. The main objective of this study is to know the influence of chronic treatment with ICS on the prognosis of COVID-19 hospitalized patients with CLD. Methods A multicenter retrospective cohort study was designed, including patients hospitalized with COVID-19. Epidemiological and clinical data were collected at admission and at seven days, and clinical outcomes were collected. Patients with CLD with and without chronic treatment with ICS were compared. Results Two thousand five hundred ninety-eight patients were included, of which 1,171 patients had a diagnosis of asthma and 1,427 of COPD (53.37% and 41.41% with ICS, respectively). No differences were found in mortality, transfer to ICU, or development of moderate-severe ARDS. Patients with chronic ICS had a longer hospital stay in both asthma and COPD patients (9 vs. 8 days, p = 0.031 in asthma patients), (11 vs. 9 days, p = 0.018 in COPD patients); although they also had more comorbidity burden. Conclusions Patients with chronic inhaled corticosteroids had longer hospital stays and more chronic comorbidities, measured by the Charlson comorbidity index, but they did not have more severe disease at admission, evaluated with qSOFA and PSI scores. Chronic treatment with inhaled corticosteroids had no influence on the prognosis of patients with chronic lung disease and COVID-19.

Publisher

Canadian Society of Respiratory Therapists

Reference38 articles.

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2. The impact of COPD and smoking history on the severity of COVID-19: A systemic review and meta-analysis;Q. Zhao;J Med Virol,2020

3. Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2;M. Gómez Antúnez;Int J Chron Obstruct Pulmon Dis,2021

4. Inhaled corticosteroids in virus pandemics: a treatment for COVID-19?;D. V. Nicolau;Lancet Respir Med,2020

5. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study [published correction appears in Lancet. 2020 Mar 28;395(10229):1038];F. Zhou;Lancet,2020

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