Inhaled corticosteroids may have a place in treatment of COVID-19

Inhaled corticosteroids may have a place in treatment of COVID-19

Vanessa Jordan
PEARLS No.
696
Clinical question

How effective and safe are inhaled corticosteroids for the treatment of coronavirus disease 2019 (COVID-19)?

Bottom line

The following conclusions were made for people with a confirmed diagnosis of COVID‐19 and mild disease:

Inhaled corticosteroids may result in little to no difference in all‐cause mortality in outpatients with mild COVID‐19 (low‐certainty evidence).

Inhaled corticosteroids probably reduce the risk of admission to hospital or death up to day 30 (moderate‐certainty evidence). Further, the intervention probably increases the resolution of all initial symptoms at day 14 (moderate‐certainty evidence) and may decrease the duration to symptom resolution (low‐certainty evidence).

Inhaled corticosteroids may result in little to no difference in the incidence of mild to moderate adverse events (low-certainty evidence). In terms of serious adverse events, the evidence is very uncertain (very‐low-certainty evidence).

Caveat

All studies investigated participants with mild disease in outpatient settings. Currently, there is no evidence for people with asymptomatic COVID-19 or inpatients with moderate to severe disease.

Context

Inhaled corticosteroids are well established for the long‐term treatment of inflammatory respiratory diseases, such as asthma or chronic obstructive pulmonary disease. They have been investigated for the treatment of COVID‐19. The anti‐inflammatory action of inhaled corticosteroids might have the potential to reduce the risk of severe illness resulting from hyperinflammation in COVID‐19.

Cochrane Systematic Review

Griesel M, Wagner C, Mikolajewska A, et al. Inhaled corticosteroids for the treatment of COVID‐19. Cochrane Database Syst Rev 2022;3:CD015125. This review contains 3 trials with a total of 2164 participants.