Lee Sang Chul, Son Kang Ju, Han Chang Hoon, Jung Ji Ye, Park Seon Cheol
Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2022 Jan;85(1):80-88. doi: 10.4046/trd.2021.0102. Epub 2021 Nov 30.
Although it is known that inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Thus, the aim of this study was to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among patients with chronic respiratory diseases.
Nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15, 2021 were obtained from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The positivity of SARS-CoV-2 infection was retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test.
Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. A multivariate analysis showed no significant increase in infection with ICS use (odds ratio, 0.84; 95% confidence interval, 0.66-1.03). Moreover, there were no associations between the positivity of infection and the dose or type of ICS prescribed.
Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect this positivity.
虽然已知吸入性糖皮质激素（ICS）的使用可能会增加呼吸道感染的风险，但其对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染风险的影响仍不清楚。因此，本研究的目的是调查慢性呼吸道疾病患者中ICS的使用与SARS-CoV-2感染阳性之间的关联。
从韩国卫生与福利部以及健康保险审查与评估服务机构获取了截至2021年5月15日接受SARS-CoV-2检测的44968例慢性呼吸道疾病患者的全国性数据。根据SARS-CoV-2检测前一年服用的ICS的处方、类型和剂量，对SARS-CoV-2感染阳性情况进行回顾性分析。
在44968例接受检测的个体中，931例（2.1%）SARS-CoV-2检测呈阳性。共有7019例患者（15.6%）在接受SARS-CoV-2检测前一年被处方使用ICS。低、中、高剂量ICS的处方分别占总病例的7.5%、1.6%和6.5%。在ICS类型中，布地奈德、氟替卡松、倍氯米松和环索奈德的处方分别占总病例的3.7%、8.9%、2.3%和0.6%。多因素分析显示，使用ICS不会显著增加感染风险（比值比，0.84；95%置信区间，0.66 - 1.03）。此外，感染阳性与所处方的ICS剂量或类型之间没有关联。
既往使用ICS不会增加SARS-CoV-2感染的阳性率。此外，不同剂量或类型的ICS不会影响这一阳性率。
