Systemic Corticosteroid Use Linked to Worse COVID-19 Outcomes
September 27, 2021
1 minute read
Source / Disclosures
Yochai A, et al. Asthma treatment: clinical and translational science. Presented at: International Congress of the European Respiratory Society; Sep 5-8, 2021 (virtual meeting).
Disclosures: Yochai claims to have received grants from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline and Janssen and consulting fees or fees from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Janssen, Kameda, Novartis and Teva.
In a new study, biologics approved for asthma and systemic corticosteroids were not associated with an increased risk of SARS-CoV-2 infection, but the use of systemic corticosteroids was linked to worse outcomes COVID-19.
“Unlike other respiratory viruses, which are a major cause of acute asthma associations, asthma patients are not at increased risk of exacerbation when infected with SARS-CoV-2” Adir Yochaï, MARYLAND, from the pulmonary division of Lady Davis Carmel Medical Center and the Faculty of Medicine at the Technion Institute of Technology in Haifa, Israel, said during a presentation at the European Respiratory Society Virtual International Congress. “However, the management of COVID-19 in severe asthma patients remains difficult, and it is not clear whether a patient with severe asthma might be at greater risk for a worse outcome, at least in part due to problems with it. safety associated with therapies such as biological or systemic corticosteroids. “
Researchers evaluated the electronic health records of 82,602 adults with asthma in Israel who underwent polymerase chain reaction tests for SARS-CoV-2 between March and December 2020. Yochai and his colleagues aimed to assess associations between the use of biologics for asthma or systemic corticosteroids and COVID-19 severity and mortality at 90 days.
Overall, 8,242 patients (10.2%) tested positive for COVID-19 infection. Of these, 1,358 patients had already been treated with systemic corticosteroids and 50 were receiving biological therapy for asthma.
Researchers have not reported any association between the use of biologics or systemic corticosteroids and an increased risk of SARS-CoV-2 infection.
Biologic therapy was also not associated with an increased risk of moderate to severe COVID-19 or 90-day all-cause mortality, Yochai said.
When researchers evaluated systemic corticosteroid use, chronic and recent use (in the past 120 days) was significantly associated with an increased risk of moderate to severe COVID-19 and 90-day all-cause mortality. As the number of filled systemic corticosteroid prescriptions increased, the risk of severity and death from COVID-19 increased, according to Yochai.
Previous studies have suggested that low eosinophils are associated with increased severity of COVID-19; in this study, significantly lower eosinophils were not associated with increased severity and mortality, Yochai said.
“Our results underscore the need for optimized management of asthma patients to control asthma and avoid as much as possible the need for chronic or recurrent use of systemic corticosteroids,” said Yochai.