Factors associated with improved outcome of inhaled corticosteroid use in COVID-19: A single institutional study

Abstract

Asthmatics seem less prone to adverse outcomes in coronavirus disease 2019 (COVID-19) and some data shows that inhaled corticosteroids (ICS) are protective. We gathered data on anecdotal ICS and outcomes of patients hospitalized with COVID-19, given there is literature supporting ICS may reduce risk of severe infection. In addition, we fill gaps in current literature evaluating Charlson Comorbidity Index (CCI) as a risk assessment tool for COVID-19. This was a single-center, retrospective study designed and conducted to identify factors associated intubation and inpatient mortality. A multivariate logistic regression model was fit to generate adjusted odds ratios (OR). Intubation was associated with male gender (OR, 2.815; 95% confidence interval [CI], 1.348–5.881; P = .006) and increasing body mass index (BMI) (OR, 1.053; 95% CI, 1.009–1.099; P = .019). Asthma was associated with lower odds for intubation (OR, 0.283; 95% CI, 0.108–0.74; P = .01). 80% of patients taking pre-hospital ICS were not intubated (n = 8). In-patient mortality was associated with male gender (OR, 2.44; 95% CI, 1.167–5.1; P = .018), older age (OR, 1.096; 95% CI, 1.052–1.142; P = <.001), and increasing BMI (OR, 1.079; 95% CI, 1.033–1.127; P = .001). Asthma was associated with lower in-patient mortality (OR, 0.221; 95% CI, 0.057–0.854; P = .029). CCI did not correlate with intubation (OR, 1.262; 95% CI, 0.923–1.724; P = .145) or inpatient mortality (OR, 0.896; 95% CI, 0.665–1.206; P = .468). Asthmatics hospitalized for COVID-19 had less adverse outcomes, and most patients taking pre-hospital ICS were not intubated. CCI score was not associated with intubation or inpatient mortality.

Methylprednisolone or dexamethasone? How should we choose to respond to COVID-19?: A systematic review and meta-analysis of randomized controlled trials

“…[5] Consequently, patients with COVID-19 have been treated with immunosuppressive medications, such as corticosteroids. [6] However, corticosteroids' role in COVID-19 treatment remains under discussion. [7] Corticosteroids have become a popular therapeutic option for COVID-19 patients with hypoxia following the RECOVERY trial demonstration of a mortality benefit with low-dose dexamethasone (6 mg).…”

“…[5] Consequently, patients with COVID-19 have been treated with immunosuppressive medications, such as corticosteroids. [6] However, corticosteroids’ role in COVID-19 treatment remains under discussion. [7]…”