Treatment Experience With Inhaled Corticosteroids in Combination with Remdesivir and Dexamethasone Among COVID-19 Patients Admitted to a Rural Community Hospital: A Case Series.

Background Pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause severe inflammation of the lungs resulting in acute respiratory distress syndrome (ARDS). Current treatment guidelines support use of remdesivir as well as dexamethasone in hypoxic patients. There is very little information known about use of inhaled corticosteroids (ICS) in combination with the other two medications.  Methods and outcomes We report our experience among six coronavirus disease 2019 (COVID-19) patients who received ICS, remdesivir and dexamethasone for treatment as well as their outcomes. Data were obtained from retrospective chart review during a two-week period from July 8, 2020 to July 22, 2020. Five patients were treated successfully and discharged home. One patient expired. Conclusions This case series highlights the possible benefits of inhaled steroids in treatment of COVID-19 patients with hypoxia. Further randomized controlled studies are needed to assess inhaled corticosteroids as possible treatment either alone or in combination with systemic steroids for treating COVID-19 patients. Dose and optimal duration need to be studied and evaluated.