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Inhaled corticosteroids for outpatients with COVID-19: a meta-analysis

Todd C. Lee, Émilie Bortolussi-Courval, Sara Belga, Nick Daneman, Adrienne K. Chan, Ryan Hanula, Nicole Ezer, Emily G. McDonald
European Respiratory Journal 2022 59: 2102921; DOI: 10.1183/13993003.02921-2021
Todd C. Lee
1Division of Infectious Diseases, Dept of Medicine, McGill University Health Centre, Montréal, QC, Canada
2Clinical Practice Assessment Unit, Dept of Medicine, McGill University Health Centre, Montréal, QC, Canada
3Division of Experimental Medicine, Dept of Medicine, McGill University, Montréal, QC, Canada
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  • For correspondence: todd.lee@mcgill.ca
Émilie Bortolussi-Courval
3Division of Experimental Medicine, Dept of Medicine, McGill University, Montréal, QC, Canada
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Sara Belga
4Division of Infectious Diseases, Dept of Medicine, University of British Columbia, Vancouver, BC, Canada
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  • ORCID record for Sara Belga
Nick Daneman
5Division of Infectious Diseases, Dept of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Adrienne K. Chan
5Division of Infectious Diseases, Dept of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Ryan Hanula
3Division of Experimental Medicine, Dept of Medicine, McGill University, Montréal, QC, Canada
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Nicole Ezer
6Division of Respirology, Dept of Medicine, McGill University Health Centre, Montréal, QC, Canada
8For the purposes of authorship, these authors share equal credit
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Emily G. McDonald
2Clinical Practice Assessment Unit, Dept of Medicine, McGill University Health Centre, Montréal, QC, Canada
3Division of Experimental Medicine, Dept of Medicine, McGill University, Montréal, QC, Canada
7Division of General Internal Medicine, Dept of Medicine, McGill University Health Centre, Montréal, QC, Canada
8For the purposes of authorship, these authors share equal credit
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Tables

  • Supplementary Materials
  • TABLE 1

    Trial descriptions and meta-analysis results

    StudyTiming and primary outcomeTotal patientsAverage ageMalesComorbiditiesSymptom free by day 14Hospitalised
    DrugControlDrugControl
    CONTAIN (placebo)≤6 days of symptoms
    Resolution of cough, dyspnoea, and fever day 7
    2033746.3%20.2% overall
    5.9% HTN
    2.5% diabetes
    0.5% CAD
    57/10544/986/1053/98
    Covis Pharma (placebo)≤72 h of test
    Time to symptom free
    4004344.8%22% HTN
    7.5% diabetes
    81/19776/2033/1977/203
    STOIC (open label)≤7 days of symptoms
    COVID-19 urgent visits
    1394542.4%Median of 1
    8.4% CAD
    5% diabetes
    63/7048/692/7011/69
    PRINCIPLE (open label)≤14 days of symptoms
    COVID-19 related hospitalisation or death
    1719 (concurrent)6448.5%80% (median of 1)
    43–46% HTN
    20–23% diabetes
    15–17% CAD
    251/781173/79472/78798/799
    AnalysisPooled risk ratioProbability any benefitProbability NNT ≤50Probability NNT ≤20
    RandomFixedRandomFixedRandomFixedRandomFixed
    Symptom free day 14 (I2 30%)1.29 (1.14–1.47)1.31 (1.18–1.45)100%100%99.8%100%93.1%98.2%
    Placebo-controlled (I2 0%)1.15 (0.95–1.38)1.15 (0.95–1.38)92.5%92.7%78.1%78.2%42.6%43.4%
    Open label (I2 11.9%)1.39 (1.22–1.58)1.39 (1.23–1.56)100%100%100%100%99.3%99.8%
    Hospitalisation; overall (I2 49.2%)0.64 (0.31–1.29)0.72 (0.55–0.95)89.3%99.0%72.9%78.2%26.7%0.7%
    Placebo-controlled (I2 54.4%)0.90 (0.22–3.71)0.90 (0.35–2.33)54.7%57.6%43.0%40.1%21.6%12.3%
    Open label (I2 71.3%)0.44 (0.12–1.70)0.71 (0.59–0.94)89.1%99.8%81.3%85.3%57.6%0.3%

    COVID-19: coronavirus disease 2019; HTN: hypertension; CAD: coronary artery disease; NNT: number needed to treat.

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    Inhaled corticosteroids for outpatients with COVID-19: a meta-analysis
    Todd C. Lee, Émilie Bortolussi-Courval, Sara Belga, Nick Daneman, Adrienne K. Chan, Ryan Hanula, Nicole Ezer, Emily G. McDonald
    European Respiratory Journal May 2022, 59 (5) 2102921; DOI: 10.1183/13993003.02921-2021

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    Inhaled corticosteroids for outpatients with COVID-19: a meta-analysis
    Todd C. Lee, Émilie Bortolussi-Courval, Sara Belga, Nick Daneman, Adrienne K. Chan, Ryan Hanula, Nicole Ezer, Emily G. McDonald
    European Respiratory Journal May 2022, 59 (5) 2102921; DOI: 10.1183/13993003.02921-2021
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