Department of Medicine, National Jewish Health, Denver, CO, United States; Department of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States; Colorado School of Public Health, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States.
Department of Medicine, National Jewish Health, Denver, CO, United States; Department of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, United States.
Respir Med. 2021 Jan;176:106275. doi: 10.1016/j.rmed.2020.106275. Epub 2020 Nov 28.
The effects of chronic inhaled and systemic corticosteroids use on COVID-19 susceptibility and severity are unclear. Since many patients with chronic pulmonary diseases rely on corticosteroids to control disease, it is important to understand the risks of their use during the pandemic. We aim to study if the use of inhaled or systemic corticosteroids affects the likelihood of developing COVID-19 infection.
We used the National Jewish Health electronic medical record research database to identify a cohort of all subjects who were tested for suspected COVID-19 between March 11 - June 23, 2020. Testing results, medication use, and comorbidities were obtained from the medical record. Following a comparison of different propensity score weighting methods, overlap propensity score weighting was used to analyze the association between medication use and COVID-19 diagnosis.
The cohort consisted of 928 patients, of which 12% tested positive. The majority (66%) of patients had a history of chronic pulmonary diseases. There was no significant association between inhaled corticosteroid use and testing positive for COVID-19. Interestingly, systemic corticosteroid use was associated with a lower odds ratio (0.95, 95% CI: 0.91-0.99) of testing positive for COVID-19. Similar results were noted when the analysis was restricted to those with any chronic pulmonary diseases, with asthma or with chronic obstructive pulmonary disease (COPD).
Our study supports the recommendation that patients with chronic pulmonary diseases, including asthma and COPD who require treatment with either inhaled or systemic corticosteroids, should continue their use during the COVID-19 pandemic.
慢性吸入性和全身性皮质类固醇的使用对 COVID-19 的易感性和严重程度的影响尚不清楚。由于许多患有慢性肺部疾病的患者依赖皮质类固醇来控制疾病，因此了解大流行期间使用皮质类固醇的风险非常重要。我们旨在研究吸入性或全身性皮质类固醇的使用是否会影响 COVID-19 感染的可能性。
我们使用了 National Jewish Health 电子病历研究数据库，以确定 2020 年 3 月 11 日至 6 月 23 日期间所有疑似 COVID-19 患者的队列。从病历中获取了测试结果、药物使用情况和合并症。在比较了不同倾向评分加权方法后，使用重叠倾向评分加权来分析药物使用与 COVID-19 诊断之间的关联。
该队列包括 928 名患者，其中 12%的患者检测结果为阳性。大多数（66%）患者有慢性肺部疾病病史。吸入皮质类固醇的使用与 COVID-19 检测呈阳性之间没有显著关联。有趣的是，全身性皮质类固醇的使用与 COVID-19 检测呈阳性的几率较低相关（0.95，95%CI：0.91-0.99）。当分析仅限于患有任何慢性肺部疾病、哮喘或慢性阻塞性肺疾病（COPD）的患者时，也观察到了类似的结果。
我们的研究支持了这样的建议，即需要使用吸入性或全身性皮质类固醇治疗的慢性肺部疾病（包括哮喘和 COPD）患者，在 COVID-19 大流行期间应继续使用。
