Project #38:
Inhaled corticosteroids and risk of COVID-19 death.

This study aimed to evaluate how regular use of a type of drug used to treat respiratory diseases, inhaled corticosteroids (ICS), might have influenced the risk of dying from COVID-19 during the first wave of the pandemic. We studied two groups of people - those with asthma, and those with chronic obstructive pulmonary disease (COPD) - and compared their risk of death from COVID-19. We used a number of techniques to try and account for the fact that people who receive treatments such as ICS are different from those who do not.

We found that:

• For people with COPD, those who were prescribed ICS were at higher risk of dying from COVID-19 compared to those not receiving ICS treatments.
• For people with asthma, those receiving high-dose (but not low-dose) ICS were at higher risk of dying compared to those individuals receiving a non-steroid based reliever inhaler (called salbutamol).

However, our study results also suggest that the higher risk of death in individuals taking ICS might not be fully related to the use of the ICS medication, and might also be related to other factors, for example, people using ICS typically have more severe lung disease, which might explain the reason why they have a higher risk of COVID-19 related death.

We therefore concluded that our study provided no convincing evidence that use of ICS was associated with an increased risk of dying from COVID-19 during the first wave of the pandemic, which should be seen as reassuring for people with these respiratory diseases who rely on ICS to manage their respiratory symptoms.