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http://dx.doi.org/10.4046/trd.2021.0102

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)
Publication Information
Tuberculosis and Respiratory Diseases / v.85, no.1, 2022 , pp. 80-88 More about this Journal
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
Inhaled Corticosteroid; Severe Acute Respiratory Syndrome Coronavirus 2; Chronic Respiratory Diseases; Risk;
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