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Inhaler technique and adherence may significantly affect outcomes Tichopád.
Budesonide was adopted
in all or part of 8 countries (9 including non-government medical organizations).
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Summary.
Dec 23 |
Budesonide reduces COVID-19 risk: real-time meta analysis of 15 studies | |
| Significantly lower risk is seen for mortality, ICU admission, hospitalization, progression, recovery, and cases. 11 studies from 11 independent teams in 7 countries show significant benefit. Meta analysis using the most serious outcome r.. | ||
May 30 |
et al., The Clinical Respiratory Journal, doi:10.1111/crj.13790 | COPD patients with high blood eosinophil counts exhibit a lower rate of omicron infection and milder post‐infection symptoms |
| 31% lower hospitalization (p=0.18) and 24% fewer cases (p=0.0001). Retrospective 315 COPD patients in China showing significantly lower COVID-19 cases with budesonide/formoterol or budesonide/glycopyrronium/formoterol use. Note that Table 4 includes only infected patients, we show the COVID-19 hospitaliz.. | ||
Feb 28 |
et al., medRxiv, doi:10.1101/2024.02.26.24302674 | Single cell sequencing reveals cellular landscape alterations in the airway mucosa of patients with pulmonary long COVID |
| Single-cell RNA sequencing study of airway cells from patients with persistent respiratory symptoms due to COVID-19 infection (pulmonary long COVID) over 1 year after initial infection. Authors found increased neutrophils and neutrophil a.. | ||
Jan 6 |
et al., BMJ Open Respiratory Research, doi:10.1136/bmjresp-2023-001874 | Adherence to application technique of inhaled corticosteroid in patients with asthma and COVID-19 improves outcomes |
| Retrospective 654 asthma patients in the Czech Republic and Slovakia diagnosed with COVID-19 showing improved COVID-19 outcomes, including lower risk of hospitalization and faster recovery of lung function, with better adherence to inhale.. | ||
Dec 14 2023 |
et al., BMJ Open, doi:10.1136/bmjopen-2023-075803 | Inhaled beclomethasone in the treatment of early COVID-19: a double-blind, placebo-controlled, randomised, hospital-based trial in Sri Lanka |
| RCT 385 asymptomatic, mild or moderate COVID-19 patients in Sri Lanka showing no significant difference in progression to severe disease with inhaled beclomethasone. There was a reduction in time to clinical recovery in patients initially.. | ||
Nov 28 2023 |
et al., PLOS ONE, doi:10.1371/journal.pone.0294872 | Clinical efficacy of inhaled corticosteroids in patients with coronavirus disease 2019: A living review and meta-analysis |
| 55% lower hospitalization (p=0.26) and 25% improved recovery (p<0.0001). Systematic review and meta-analysis of 8 randomized controlled trials (2,788 patients) comparing inhaled corticosteroids (ICS) to placebo or usual care for the treatment of COVID-19. Overall, ICS treatment was associated with improved cli.. | ||
Nov 27 2023 |
, S., Open Forum Infectious Diseases, doi:10.1093/ofid/ofad500.600 | Clinical efficacy of inhaled corticosteroids in patients with coronavirus disease-2019: an updated systematic review and meta-analysis |
| 25% improved recovery (p<0.0001). Systematic review and meta analysis showing improved recovery with budesonide. | ||
Nov 21 2023 |
et al., QJM: An International Journal of Medicine, doi:10.1093/qjmed/hcad262 | Effective early strategy to prevent olfactory and gustatory dysfunction in COVID-19: a randomized controlled trial |
| 79% lower progression (p<0.0001) and 97% lower severe cases (p<0.0001). RCT 379 mild COVID-19 cases showing significantly lower prevalence and severity of olfactory and gustatory dysfunction with budesonide nasal spray, chlorhexidine mouthwash, and saline nasal irrigation. The control group received no interv.. | ||
Nov 1 2023 |
et al., Frontiers in Pharmacology, doi:10.3389/fphar.2023.1204297 | Associations between COVID-19 outcomes and asthmatic patients with inhaled corticosteroid |
| PSM retrospective 64,587 asthmatic patients using inhaled corticosteroids (ICS) and 64,587 matched controls without ICS use. ICS medications included budesonide, mometasone, flunisolide, beclomethasone, fluticasone, and ciclesonide. ICS u.. | ||
Sep 30 2023 |
et al., International Journal of Academic Medicine and Pharmacy, doi:10.47009/jamp.2023.5.5.101 | To estimate the efficacy of inhaled corticosteroid in-patient of moderate COVID-19 pneumonia - randomized controlled study |
| 43% lower mortality (p=0.52), 78% lower ICU admission (p<0.0001), and 70% improved recovery (p<0.0001). RCT inhaled budesonide with 80 moderate COVID-19 pneumonia patients. The budesonide group had significantly faster time to clinical improvement, fewer ICU admissions, shorter oxygen therapy duration, and lower mortality. Inhaled budesonid.. | ||
Aug 31 2023 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2023.08.022 | Local budesonide therapy in the management of persistent hyposmia in suspected non-severe COVID-19 patients: Results of a randomized controlled trial |
| RCT 123 post-COVID-19 hyposmia patients, showing no significant difference in smell recovery with budesonide. 2 patients experienced improvement of more than two points on the ODORATEST score compared with 0 in the control group. | ||
Aug 2 2023 |
et al., PLOS ONE, doi:10.1371/journal.pone.0288285 | Effect of any form of steroids in comparison with that of other medications on the duration of olfactory dysfunction in patients with COVID-19: A systematic review of randomized trials and quasi-experimental studies |
| Review of the effects of various treatment options and interventions for COVID-19-related olfactory dysfunction. Authors analyzed 21 studies with a total of 130,550 patients to compare the efficacy of corticosteroid treatments with other .. | ||
Aug 1 2023 |
et al., NCT04920838 | Early Treatment of Vulnerable Individuals With Non-Severe SARS-CoV-2 Infection: A Multi-Arm Multi-Stage Randomized Trial (MAMS) to Evaluate the Effectiveness of Several Specific Treatments in Reducing the Risk of Clinical Worsening or Death in Sub-Saharan Africa (COVERAGE-Africa) |
| Estimated 600 patient budesonide early treatment RCT with results not reported over 1 year after estimated completion. | ||
Apr 17 2023 |
et al., Annals of Internal Medicine, doi:10.7326/M22-3305 | Oral Fluvoxamine With Inhaled Budesonide for Treatment of Early-Onset COVID-19 |
| 12% lower hospitalization (p=1) and 50% lower progression (p=0.04). Low-risk (1% hospitalization) outpatient RCT with 738 fluvoxamine + budesonide patients and 738 placebo patients, showing significantly lower hospitalization/ER visits with treatment. | ||
Mar 3 2023 |
et al., Lung India, doi:10.4103/lungindia.lungindia_268_22 | Effectiveness of budesonide formoterol fixed-dose combination MDI in reducing cough symptoms in COVID-19 patients: A real-world evidence study |
| 69% lower hospitalization (p=0.07) and 29% improved recovery (p=0.008). Prospective study of 102 patients in India, showing improved recovery of cough with budesonide+formoterol. Authors note better results with earlier treatment. Budesonide 800mcg + formoterol 12mcg bid for 7 days. | ||
Nov 1 2022 |
, NCT05055414 | A Multi-center, Randomized, Double-blind, Placebo-controlled, Parallel, Phase 2 Study to Evaluate the Efficacy and Safety of UI030 in COVID-19 Patients |
| Estimated 140 patient budesonide early treatment RCT with results not reported over 2 years after estimated completion. | ||
Aug 31 2022 |
et al., Open Medicine, doi:10.1515/med-2022-0569 | The relationship between oxygen therapy, drug therapy, and COVID-19 mortality |
| 11% higher mortality (p=0.85). Retrospective 185 hospitalized COVID-19 patients in China, showing no significant difference in mortality with budesonide use in unadjusted results. | ||
Aug 16 2022 |
et al., Virology Journal, doi:10.1186/s12985-023-02195-9 (date from preprint) | Real-world evidence with a retrospective cohort of 15,968 COVID-19 hospitalized patients suggests 21 new effective treatments |
| 22% lower mortality (p=0.004). Retrospective 15,968 COVID-19 hospitalized patients in Spain, showing lower mortality with existing use of several medications including metformin, HCQ, azithromycin, aspirin, vitamin D, vitamin C, and budesonide. Since only hospitalized .. | ||
Apr 18 2022 |
et al., Clinical Immunology, doi:10.1016/j.clim.2022.109016 | Combined administration of inhaled DNase, baricitinib and tocilizumab as rescue treatment in COVID-19 patients with severe respiratory failure |
| 74% lower mortality (p=0.05), 76% lower ventilation (p=0.02), and 20% shorter hospitalization (p=0.02). Small retrospective study of hospitalized patients with severe respiratory failure, 22 treated with a combination of budesonide, tocilizumab, baricitinib, dornase alfa, and salbutamol or/and ipratropium, and 26 SOC patients, showing lower.. | ||
Mar 22 2022 |
et al., International Journal of Scientific Development and Research, 7:3 | Effectiveness of Inhaled Steroids in Post COVID Cough |
| 33% lower need for oxygen therapy (p=0.009), 26% shorter hospitalization (p=0.02), and 37% faster recovery (p=0.001). Retrospective 120 hospitalized COVID-19 patients with persistent cough in India, showing faster resolution of cough, shorter duration of oxygen support, and shorter hospitalization with inhaled budesonide treatment compared to standard of.. | ||
Mar 16 2022 |
et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2022.02.031 | Inhaled ciclesonide for outpatient treatment of COVID-19 in adults at risk of adverse outcomes: a randomised controlled trial (COVERAGE) |
| 80% lower mortality (p=0.24), 36% higher hospitalization (p=0.52), and 20% higher progression (p=0.69). Early terminated RCT with 110 ciclesonide patients and 107 patients treated with vitamins A, B1, B2, B3, B5, B6, B8, B9, B12, C, D3, and E, calcium, chromium, copper, iron, manganese, molybdenum, selenium, and zinc (Azinc Vitality), show.. | ||
Feb 10 2022 |
et al., European Respiratory Journal, doi:10.1183/13993003.03036-2021 | Add-on inhaled budesonide in the treatment of hospitalised patients with COVID-19: a randomised clinical trial |
| 23% higher mortality (p=1) and 39% lower progression (p=0.69). Small early-terminated RCT with 40 inhaled budesonide and 49 control patients, showing no significant differences. 400µg/12h via Pulmicort Turbuhaler. | ||
Jan 8 2022 |
et al., Pharmaceuticals, doi:10.3390/ph15010078 | A Case-Control of Patients with COVID-19 to Explore the Association of Previous Hospitalisation Use of Medication on the Mortality of COVID-19 Disease: A Propensity Score Matching Analysis |
| 49% lower mortality (p=0.01). PSM retrospective 3,712 hospitalized patients in Spain, showing lower mortality with existing use of azithromycin, bemiparine, budesonide-formoterol fumarate, cefuroxime, colchicine, enoxaparin, ipratropium bromide, loratadine, mepyramine.. | ||
Dec 31 2021 |
et al., Interdisciplinary Perspectives on Infectious Diseases, doi:10.1155/2021/2129006 | Efficacy of Colchicine and Budesonide in Improvement Outcomes of Patients with Coronavirus Infection 2019 in Damascus, Syria: A Randomized Control Trial |
| 7% higher mortality (p=1) and 20% shorter hospitalization. Small RCT 49 severe condition hospitalized patients in Syria, showing lower mortality with colchicine and shorter hospitalization time with both colchicine and budesonide (all of these are not statistically significant). | ||
Nov 22 2021 |
et al., JAMA Internal Medicine, doi:10.1001/jamainternmed.2021.6759 | Efficacy of Inhaled Ciclesonide for Outpatient Treatment of Adolescents and Adults With Symptomatic COVID-19 |
| 54% lower hospitalization (p=0.26), 81% fewer combined hospitalization/ER visits (p=0.03), and 15% improved recovery (p=0.25). RCT 400 outpatients in the USA, showing significantly lower ER visits/hospital admission with ciclesonide treatment. NCT04377711. Publication was delayed about a year after completion and the primary endpoint was changed about 4 months af.. | ||
Nov 10 2021 |
et al., Journal of Intensive Care Medicine, doi:10.1177/08850666211053548 | The Role of Inhaled Corticosteroids (ICS) in Critically Ill Patients With COVID-19: A Multicenter, Cohort Study |
| 32% lower mortality (p=0.13). Combined retrospective (Mar-Jun 2020) and prospective (until Mar 2021) study of 954 COVID+ ICU patients in Saudi Arabia, 68 treated with ICS (80% budesonide or budesonide/formoterol, 20% fluticasone/salmeterol), showing lower mortality wi.. | ||
Oct 27 2021 |
et al., medRxiv, doi:10.1101/2021.10.26.21265512 | Dampening of the respiratory cytokine storm is promoted by inhaled budesonide in patients with early COVID-19 |
| Analysis of inflammatory mediators in the nasal mucosa of patients in the STOIC1 trial and a cohort of SARS-CoV-2 negative controls, showing that budesonide treatment decreased IL-33 and IFN-γ, implying a reduction in epithelial damage an.. | ||
Sep 9 2021 |
et al., Research Square, doi:10.21203/rs.3.rs-72221/v1 | Association Between Inhaled Corticosteroid Use and the Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Nationwide Population-based Study in South Korea |
| 33% fewer cases (p=0.1). Retrospective 44,968 patients in South Korea, 7,019 on inhaled corticosteroids, showing no statistically significant differences in COVID-19 cases. | ||
Aug 23 2021 |
et al., The Journal of Allergy and Clinical Immunology: In Practice, doi:10.1016/j.jaip.2021.08.007 | Intranasal Corticosteroids Are Associated with Better Outcomes in Coronavirus Disease 2019 |
| 24% lower mortality (p=0.01), 22% lower ICU admission (p=0.003), and 19% lower hospitalization (p<0.0001). Retrospective 72,147 COVID-19+ patients in the USA, showing lower mortality, ICU admission, and hospitalization with intranasal corticosteroid use. | ||
Jul 20 2021 |
et al., Viruses, doi:10.3390/v13071411 | Antiviral Effect of Budesonide against SARS-CoV-2 |
| In Vitro study showing dose-dependent inhibition of SARS-CoV-2 with budesonide. | ||
Jun 18 2021 |
et al., BMJ Open, doi:10.1136/bmjopen-2020-046799 | Platform Randomised trial of INterventions against COVID-19 In older peoPLE (PRINCIPLE): protocol for a randomised, controlled, open-label, adaptive platform, trial of community treatment of COVID-19 syndromic illness in people at higher risk |
| Protocol paper for the PRINCIPLE trial. For the colchicine arm see [Dorward], for budesonide see [Yu], and for ivermectin see [Hayward]. | ||
May 31 2021 |
et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2020.102892 | The outcome of fluticasone nasal spray on anosmia and triamcinolone oral paste in dysgeusia in COVID-19 patients |
| Prospective study of 120 COVID-19 patients in India showing significant improvements in smell and taste with fluticasone nasal spray and triamcinolone oral paste. In the treatment group, smell and taste significantly improved by day 5 com.. | ||
May 28 2021 |
et al., NCT04331054 | Protective Role of Inhaled Steroids for Covid-19 Infection |
| 146 patient budesonide late treatment RCT with results not reported over 3 years after completion. | ||
May 5 2021 |
et al., bioRxiv, doi:10.1101/2021.05.05.442779 | ProLung™-budesonide Inhibits SARS-CoV-2 Replication and Reduces Lung Inflammation |
| In Vitro study and animal study showing that ProLung™-budesonide inhibits SARS-CoV-2 replication (results for budesonide were not provided). ProLung™-budesonide and budesonide significantly decreased lung inflammation. ProLung™-budesonide.. | ||
Apr 12 2021 |
et al., The Lancet, doi:10.1016/S0140-6736(21)01744-X (date from preprint) | Inhaled budesonide for COVID-19 in people at high risk of complications in the community in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial |
| 39% lower mortality (p=0.45), 6% lower ventilation (p=1), 52% lower ICU admission (p=0.07), and 25% lower combined mortality/hospitalization (p=0.96). Results from the PRINCIPLE trial, 1,073 treated with budesonide starting a median of 6 days after symptom onset, showing lower hospitalization/death, and faster recovery with treatment. | ||
Mar 30 2021 |
et al., Thorax, doi:10.1136/thoraxjnl-2021-217487 | Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK) |
| 32% fewer cases (p=0.03). Prospective survey-based study with 15,227 people in the UK, showing lower risk of COVID-19 cases with vitamin A, vitamin D, zinc, selenium, probiotics, and inhaled corticosteroids; and higher risk with metformin and vitamin C. Statistica.. | ||
Feb 8 2021 |
et al., Lancet Respiratory Medicine, doi:10.1016/S2213-2600(21)00160-0 (date from preprint) | Inhaled budesonide in the treatment of early COVID-19 (STOIC): a phase 2, open-label, randomised controlled trial |
| 82% fewer combined hospitalization/ER visits (p=0.02) and 67% improved recovery (p=0.003). RCT with 73 budesonide patients and 73 control patients, showing significantly lower combined risk of an ER visit or hospitalization, and lower risk of no recovery at day 14. | ||
Oct 18 2020 |
et al., medRxiv, doi:10.1101/2020.10.15.20213546 | Melatonin is significantly associated with survival of intubated COVID-19 patients |
| 71% lower mortality (p=0.01). Retrospective 948 intubated patients, 33 treated with budesonide, showing lower mortality with treatment. | ||
May 20 2020 |
et al., NCT04331470 | Evaluation of Efficacy of Pharmacotherapy Treatment of COVID-19 Infection Using Oral Levamisole and Formoterol+Budesonide Inhaler and Comparison of This Treatment Protocol With Standard National Treatment of the Disease |
| Estimated 30 patient budesonide early treatment RCT with results not reported over 4 years after estimated completion. | ||
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