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Associations between COVID-19 outcomes and asthmatic patients with inhaled corticosteroid

Yong et al., Frontiers in Pharmacology, doi:10.3389/fphar.2023.1204297
Nov 2023  
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Budesonide for COVID-19
20th treatment shown to reduce risk in April 2021
*, now known with p = 0.000025 from 14 studies, recognized in 8 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
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 use was associated with a higher risk of COVID-19 infection (hazard ratio 1.383) but lower risks of hospitalization (HR 0.664), emergency department visits (HR 0.774), and mortality (HR 0.834).
Yong et al., 1 Nov 2023, retrospective, USA, peer-reviewed, 6 authors, study period January 2020 - December 2022. Contact:,
This PaperBudesonideAll
Associations between COVID-19 outcomes and asthmatic patients with inhaled corticosteroid
Su-Boon Yong, Shuo-Yan Gau, Chia-Jung Li, Chih-Wei Tseng, Shiow-Ing Wang, James Cheng-Chung Wei
Frontiers in Pharmacology, doi:10.3389/fphar.2023.1204297
Background: The impact of inhaled corticosteroid (ICS) in the interaction between asthma, COVID-19 and COVID-19 associated outcomes remain largely unknown. The objective of this study is to investigate the risk of COVID-19 and its related outcomes in patients with asthma using and not using inhaled corticosteroid (ICS). Methods: We used the TriNetX Network, a global federated network that comprises 55 healthcare organizations (HCO) in the United States, to conduct a retrospective cohort study. Patients with a diagnosis of asthma with and without ICS between January 2020 and December 2022 were included. Propensity score matching was used to match the case cohorts. Risks of COVID-19 incidence and medical utilizations were evaluated. Results: Out of 64,587 asthmatic patients with ICS and without ICS, asthmatic patients with ICS had a higher incidence of COVID-19 (Hazard ratio, HR: 1.383, 95% confidence interval, CI: 1.330-1.437). On the contrary, asthmatic patients with ICS revealed a significantly lower risk of hospitalization (HR: 0.664, 95% CI: 0.647-0.681), emergency department visits (HR: 0.774, 95% CI: 0.755-0.793), and mortality (HR:0.834, 95% CI:0.740-0.939). In addition, subgroup or sensitivity analyses were also conducted to examine the result of different vaccination status, disease severity, or COVID-19 virus variants. Conclusion: For asthmatic patients using ICS, risk of COVID-19 was significantly higher than non-users. The observed association could provide potential guidance for primary care physicians regarding the risk of COVID-19 in asthmatic patients.
Ethics statement The studies involving humans were approved by the Institutional Review Board of Chung Shan Medical University Hospital (CSMUH No: CS2-21176) . The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required from the participants or the participants' legal guardians/next of kin in accordance with the national legislation and institutional requirements. Author contributions Study conception and design: S-BY, C-WT, S-IW, C-JL, S-YG, and J-CW. Data acquisition: S-BY and J-CW. Data analysis and demonstration: S-BY, C-WT, S-IW, and S-YG. Original draft preparation: S-BY, C-WT, S-IW, S-YG, C-JL, and J-CW. All authors contributed to the article and approved the submitted version. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Supplementary material The Supplementary Material for this article can be found online at:..
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