Intranasal Corticosteroids are Associated with Better Outcomes in Coronavirus Disease 2019 (COVID-19)

Autor: Strauss, Ronald, Jawhari, Nesreen, Attaway, Amy H., Hu, Bo, Jehi, Lara, Milinovich, Alex, Ortega, Victor E., Zein, Joe G.
Jazyk: angličtina
Rok vydání: 2021
Předmět:
OR
Odds Ratio
NSAIDs
Non-steroidal anti-inflammatory drugs
MICE
Multivariate Imputation by Chained Equations
BMI
Body mass index
CCCRR
Cleveland Clinic COVID-19 Research Registry
Methylprednisolone
INCS
Intranasal corticosteroids
Adrenal Cortex Hormones
ACE2
Angiotensin Converting Enzyme 2
TMPRSS2
Transmembrane Serine Protease 2
Eosinophilia
Humans
IL
Interleukin
EHR
Electronic health records
RNA
Ribonucleic acid
linps
linear propensity score
χ2
Chi-square
iCS
Inhaled corticosteroids
PS
Propensity score
RCT
Randomized controlled trial
AEC
Absolute eosinophil count
SARS-CoV-2
CI
Confidence interval
Intranasal Corticosteroids
COVID-19
IQR
Interquartile range
Asthma
S
Spike
SARP
Severe asthma research program
ICU
Intensive care unit
ARB
Angiotensin receptor blocker
SARS-CoV-2
Severe Acute Respiratory Syndrome Coronavirus 2
COPD
chronic obstructive pulmonary disease
COVID-19
Coronavirus Disease 2019
Original Article
Zdroj: The Journal of Allergy and Clinical Immunology. in Practice
ISSN: 2213-2201
2213-2198
Popis: Background Sites of entry for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are highly expressed in nasal epithelial cells, however little is known about the impact of intranasal corticosteroids (INCS) on Coronavirus Disease 2019 (COVID-19) related outcomes. Objective Determine the association between baseline INCS use and COVID-19 related outcomes. Methods Using the Cleveland Clinic COVID-19 Research Registry (CCCRR), we performed a propensity score matching for treatment with INCS prior to SARS-CoV-2 infection (April 1, 2020 - March 31, 2021). Of the 82,096 individuals who tested positive, 72,147 met inclusion criteria. Our endpoints included need for hospitalization, admission to the intensive care unit (ICU), or in-hospital mortality. Results Of the 12,608 (17.5%) who were hospitalized, 2,935 (4.1%) required ICU admission and 1,880 (2.6%) died during hospitalization. A significant proportion (n=10,187; 14.1%) were utilizing INCS prior to SARS-CoV-2 infection. Compared to non-users, INCS users demonstrated lower risk for hospitalization (adjusted OR [95% CI]: 0.78 [0.72; 0.85]), ICU admission (adjusted OR [95% CI]: 0.77 [0.65; 0.92]) and in-hospital mortality (adjusted OR [95% CI]: 0.76 [0.61; 0.94]). These findings were replicated in sensitivity analyses where patients on inhaled corticosteroids, and those with allergic rhinitis were excluded. The beneficial effect of INCS was significant after adjustment for baseline blood eosinophil count (measured prior to SARS-CoV-2 testing) in a subset of 30,289 individuals. Conclusion INCS therapy is associated with a lower risk for COVID-19-related hospitalization, ICU admission, or death. Future randomized control trials are needed to determine if INCS reduces the risk for severe outcomes related to COVID-19.
Databáze: OpenAIRE
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