The association between inhaled corticosteroid and the risks of SARS-COV-2 infection: A systematic review and meta-analysis

Chen, Chao-Hsien; Chen, Ching-Yi; Lai, Chih‐Cheng; Wang, Yahui; Chen, Kuang-Hung; Wang, Cheng Yi; Wei, Yufeng; Fu, Pin-Kuei

doi:10.1016/j.jiph.2023.03.019

Cited by 3 publications

(1 citation statement)

References 41 publications

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“…In a systematic review and meta-analysis recently published, ICS either as monotherapy or combined with inhaled bronchodilators did not increase the risk of infection from SARS-COV-2. 80 Although initial results for inhaled ciclesonide hinted that it could shorten the viral shedding duration in patients infected from COVID, 81 so far its use is not encouraged in the general population. Two open-label Phase 2 trials with budesonide yielded some positive results, however its use was not proposed in the guidelines by the National Institute for Health and Care Excellence (NICE).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations

Bakakos,

Sotiropoulou,

Vontetsianos

et al. 2023

JAA

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Asthma is a common airway disease, affecting millions of people worldwide. Although most asthma patients experience mild symptoms, it is characterized by variable airflow limitation, which can occasionally become life threatening in the case of a severe exacerbation. The commonest triggers of asthma exacerbations in both children and adults are viral infections. In this review article, we will try to investigate the most common viruses triggering asthma exacerbations and their role in asthma immunopathogenesis, since viral infections in young adults are thought to trigger the development of asthma either right away after the infection or at a later stage of their life. The commonest viral pathogens associated with asthma include the respiratory syncytial virus, rhinoviruses, influenza and parainfluenza virus, metapneumovirus and coronaviruses. All these viruses exploit different molecular pathways to infiltrate the host. Asthmatics are more prone to severe viral infections due to their unique inflammatory response, which is mostly characterized by T2 cytokines. Unlike the normal T1 high response to viral infection, asthmatics with T2 high inflammation are less potent in containing a viral infection. Inhaled and/or systematic corticosteroids and bronchodilators remain the cornerstone of asthma exacerbation treatment, and although many targeted therapies which block molecules that viruses use to infect the host have been used in a laboratory level, none has been yet approved for clinical use. Nevertheless, further understanding of the unique pathway that each virus follows to infect an individual may be crucial in the development of targeted therapies for the commonest viral pathogens to effectively prevent asthma exacerbations. Finally, biologic therapies resulted in a complete change of scenery in the treatment of severe asthma, especially with a T2 high phenotype. All available data suggest that monoclonal antibodies are safe and able to drastically reduce the rate of viral asthma exacerbations.

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Section: Introductionmentioning

confidence: 99%

Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations

Bakakos,

Sotiropoulou,

Vontetsianos

et al. 2023

JAA

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The Research Progress and Consideration on the Influence of Respiratory Infectious Dis-eases on COPD Patients Were Reviewed from the Clinical Perspective

程

2023

ACM

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Inhaled ciclesonide does not affect production of antibodies or elimination of virus in patients with COVID-19: Subanalysis of a multicenter, open-label randomized trial

Suzuki,

Matsunaga,

Miyoshi-Akiyama

et al. 2023

DD&T

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SARS-CoV-2 nucleocapsid protein antibody, asymptomatic or mild randomized clinical trial, viral load During an earlier multicenter, open-label, randomized controlled trial designed to evaluate the effectiveness of high-dose inhaled ciclesonide in patients with asymptomatic or mild coronavirus disease 2019 (COVID-19), we observed that worsening of shadows on CT without worsening of clinical symptoms was more common with ciclesonide. The present study sought to determine if an association exists between worsening CT shadows and impaired antibody production in patients treated with inhaled ciclesonide. Eighty-nine of the 90 patients in the original study were prospectively enrolled. After exclusions, there were 36 patients each in the ciclesonide and control groups. We analyzed antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein at various time points. Changes in viral load during treatment were compared. There was no significant difference in age, sex, body mass index, background clinical characteristics, or symptoms between the two groups. Although evaluation on day 8 suggested a greater tendency for worsening shadows on CT in the ciclesonide group (p = 0.072), there was no significant difference between them in the ability to produce antibodies (p = 0.379) or the maximum antibody titer during the clinical course. In both groups, worsening CT shadows and higher viral loads were observed on days 1-8, suggesting ciclesonide does not affect clearance of the virus (p = 0.134). High-dose inhaled ciclesonide did not impair production of antibodies against SARS-CoV-2 or affect elimination of the virus, suggesting that this treatment can be used safely in patients with COVID-19 patients who use inhaled steroids for asthma and other diseases.

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The association between inhaled corticosteroid and the risks of SARS-COV-2 infection: A systematic review and meta-analysis

Cited by 3 publications

References 41 publications

Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations

Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations

The Research Progress and Consideration on the Influence of Respiratory Infectious Dis-eases on COPD Patients Were Reviewed from the Clinical Perspective

Inhaled ciclesonide does not affect production of antibodies or elimination of virus in patients with COVID-19: Subanalysis of a multicenter, open-label randomized trial

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