Effectiveness of Inhaled Steroids in Post COVID Cough
Dr Sudhir Bhandari, Dr Ajeet Singh, Dr Govind Rankawat, Senior
Background: Coronavirus disease 2019 can leads to persistent cough which may need special attention for better compliance of patients. We aimed to discuss the effect of inhaled steroids (Budesonide) in treatment of post COVID persistent cough and to know role of inhaled steroids in early recovery of COVID-19 patients. Methods: This retrospective observational case-control study included a total of 120 admitted patients of COVID-19 complaining of persistent cough after exclusion of another known identifiable causes. 60 patients had history of inhaled steroids for treatment of persistent cough while another 60 patients treated with standard of care treatment taken as a control group. The patient's data concerning demography, clinical profile, severity of disease, duration of illness, oxygen support, and outcome were extracted from their medical records. All collected data were tabulated, compiled, and analyzed to establish the possible causality of pneumothorax. Results: Patients of both groups had matched demographic, clinical symptoms, and comorbid status. Patients treated with inhaled steroids along with standard of care treatment had significant fast recovery (4.85 ± 3.94 days) as compared to control group (7.68 ± 5.43 days) with P=0.0014. Patients of inhaled steroids group also had early wean off from oxygen support (5.21 v/s 7.82 days), early discharge from hospital (6.54 days' v/s 8.87 days), and lesser alleviation of COVID-19 symptoms (8.33% v/s 21.67%) with P<0.05
Conclusion: This study concluded that the inhaled budesonide along with standard of care treatment helpful to relieve post COVID persistent cough. Beside early relief in cough, inhaled steroids also useful in early withdrawal of oxygen support and early discharge from hospital.
Discussion: In this study, we evaluate the effectiveness of inhaled steroids in the treatment of persistent cough after COVID-19 infection. We also try to establish an association between use of inhaled steroids and recovery from post COVID Cough. This is a retrospective case-control observational study that includes an age-matched, gender-matched, disease severity matched and underlying chronic medical illness matched control group in order to avoid these confounding factors for pneumothorax. Explaining the exact association between COVID-19 and post COVID cough is more challenging. In this study, we found that the inhaled glucocorticoid budesonide, given for the persistent cough, might be an effective treatment for post infectious cough in COVID-19 infected patients. Inhaled budesonide is a simple, safe, well studied, inexpensive, and widely available treatment. This is also significantly helpful in in low-income and middle-income countries where the majority of currently approved COVID-19 treatments are unlikely to ever reach patients as a consequence of variable health-care systems (17) . Although systemic steroids are well documented for treatment of moderate to critical COVID-19 infection but their role is not approved for use in post infectious cough. Furthermore, inhaled budesonide could work as an adjunct to reduce pressure on health-care systems and symptomatically to felt better to patients. In this study, our eyes focused on inhaled budesonide because of the..
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