Association between inhaled corticosteroid use and COVID-19 outcomes
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Association between inhaled corticosteroid use and COVID-19 outcomes. / Husby, Anders; Pottegård, Anton; Hviid, Anders.
In: Pharmacoepidemiology and Drug Safety, Vol. 30, No. 11, 2021, p. 1486-1492.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Association between inhaled corticosteroid use and COVID-19 outcomes
AU - Husby, Anders
AU - Pottegård, Anton
AU - Hviid, Anders
PY - 2021
Y1 - 2021
N2 - BackgroundRecent evidence has established a beneficial effect of systemic corticosteroids for treatment of moderate-to-severe COVID-19.ObjectiveTo determine if inhaled corticosteroid use is associated with COVID-19 outcomes.MethodsIn 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.ResultsAmong 6267 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, 0.87–1.59) and 1.02 (95% CI, 0.78–1.32), respectively. Among 10 279 hospitalized influenza patients, of which 951 (9.2%) were admitted to ICU and 1275 (12.4%) died, the hazard ratios were 1.43 (95% CI, 0.89–2.30) and 1.11 (95% CI, 0.85–1.46) for ICU admission, and 0.80 (95% CI, 0.63–1.01) and 1.03 (95% CI, 0.87–1.22) for death compared with bronchodilator use and no ICS use overall, respectively.ConclusionOur 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.Study registrationThe study was pre-registered at encepp.eu (EUPAS35897).
AB - BackgroundRecent evidence has established a beneficial effect of systemic corticosteroids for treatment of moderate-to-severe COVID-19.ObjectiveTo determine if inhaled corticosteroid use is associated with COVID-19 outcomes.MethodsIn 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.ResultsAmong 6267 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, 0.87–1.59) and 1.02 (95% CI, 0.78–1.32), respectively. Among 10 279 hospitalized influenza patients, of which 951 (9.2%) were admitted to ICU and 1275 (12.4%) died, the hazard ratios were 1.43 (95% CI, 0.89–2.30) and 1.11 (95% CI, 0.85–1.46) for ICU admission, and 0.80 (95% CI, 0.63–1.01) and 1.03 (95% CI, 0.87–1.22) for death compared with bronchodilator use and no ICS use overall, respectively.ConclusionOur 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.Study registrationThe study was pre-registered at encepp.eu (EUPAS35897).
KW - cohort study
KW - COVID-19
KW - inhaled corticosteroids
KW - pharmacoepidemiology
U2 - 10.1002/pds.5345
DO - 10.1002/pds.5345
M3 - Journal article
C2 - 34390285
VL - 30
SP - 1486
EP - 1492
JO - Pharmacoepidemiology and Drug Safety
JF - Pharmacoepidemiology and Drug Safety
SN - 1053-8569
IS - 11
ER -
ID: 276376434