Extract
The current coronavirus 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection, raises important questions as to whether pre-morbid use or continued administration of inhaled corticosteroids (ICS) affects the outcomes of acute respiratory infections due to coronavirus. Many physicians are concerned about whether individuals positive for SARS-CoV-2 and taking ICS should continue them or stop them, given that ICS are often regarded as immunosuppressive. A number of key questions arise. Are people with asthma or COPD at increased risk of developing COVID-19? Do ICS modify this risk, either increasing or decreasing it? Do ICS influence the clinical course of COVID-19? (figure 1). Whether ICS modify the risk of developing COVID-19 or the clinical course of COVID-19 in people who do not have lung disease should also be considered (figure 1).
Abstract
There is no evidence on benefits or harms of inhaled steroids in COVID-19. It is essential that epidemiological studies of COVID-19 include detailed information on comorbidities and prior medication to help answer this question. https://bit.ly/2XVwIsa
Acknowledgements
We wish to thank Rebecca Decker, Executive Director, Global Initiative for Chronic Obstructive Lung Disease (GOLD) for her support and Wei-jie Guan and Ying Zhong for their help with the papers written in Chinese.
Footnotes
Conflict of interest: D. Singh reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Glenmark, Menarini, Mundipharma, Novartis, Pfizer, Pulmatrix, Theravance and Verona, personal fees from Cipla, Genentech, GlaxoSmithKline, Peptinnovate and Teva, outside the submitted work.
Conflict of interest: R.M. Hadfield has nothing to disclose.
Conflict of interest: D.M.G. Halpin reports personal fees from AstraZeneca, Chiesi, GlaxoSmithKline, Novartis, Pfizer and Sanofi, personal fees and non-financial support from Novartis and Boehringer Ingelheim, outside the submitted work.
Support statement: Financial support for literature searching and obtaining some of the full text papers was provided by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The authors were not funded to undertake this review.
- Received April 3, 2020.
- Accepted April 16, 2020.
- Copyright ©ERS 2020
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