Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Association between Inhaled Corticosteroid Use and SARS-CoV-2 Infection: A Nationwide Population-Based Study in South Korea

  • Lee, Sang Chul (Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital) ;
  • Son, Kang Ju (Department of Research and Analysis, National Health Insurance Service Ilsan Hospital) ;
  • Han, Chang Hoon (Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital) ;
  • Jung, Ji Ye (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Seon Cheol (Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital)
  • Received : 2021.07.01
  • Accepted : 2021.11.24
  • Published : 2022.01.31
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Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Keywords

Acknowledgement

The authors appreciate the contribution of healthcare professionals dedicated to treating SARS-CoV-2 patients in Korea and the Ministry of Health and Welfare and the Health Insurance Review & Assessment Service of Korea for sharing invaluable national health insurance claims data in a prompt manner.

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