Background

The effects of chronic inhaled and systemic corticosteroids use on COVID-19 susceptibility and severity are unclear. Since many patients with chronic pulmonary diseases rely on corticosteroids to control disease, it is important to understand the risks of their use during the pandemic. We aim to study if the use of inhaled or systemic corticosteroids affects the likelihood of developing COVID-19 infection.

Methods

We used the National Jewish Health electronic medical record research database to identify a cohort of all subjects who were tested for suspected COVID-19 between March 11 - June 23, 2020. Testing results, medication use, and comorbidities were obtained from the medical record. Following a comparison of different propensity score weighting methods, overlap propensity score weighting was used to analyze the association between medication use and COVID-19 diagnosis.

Results

The cohort consisted of 928 patients, of which 12% tested positive. The majority (66%) of patients had a history of chronic pulmonary diseases. There was no significant association between inhaled corticosteroid use and testing positive for COVID-19. Interestingly, systemic corticosteroid use was associated with a lower odds ratio (0.95, 95% CI: 0.91–0.99) of testing positive for COVID-19. Similar results were noted when the analysis was restricted to those with any chronic pulmonary diseases, with asthma or with chronic obstructive pulmonary disease (COPD).

Conclusions

Our study supports the recommendation that patients with chronic pulmonary diseases, including asthma and COPD who require treatment with either inhaled or systemic corticosteroids, should continue their use during the COVID-19 pandemic.

中文翻译：

---

慢性肺病患者吸入和全身使用皮质类固醇与 2019 年冠状病毒病 (COVID-19) 检测阳性的关联

背景

慢性吸入和全身使用皮质类固醇对 COVID-19 易感性和严重程度的影响尚不清楚。由于许多慢性肺病患者依靠皮质类固醇来控制疾病，因此了解在大流行期间使用皮质类固醇的风险非常重要。我们旨在研究吸入或全身皮质类固醇的使用是否会影响发生 COVID-19 感染的可能性。

方法

我们使用 National Jewish Health 电子病历研究数据库确定了 2020 年 3 月 11 日至 6 月 23 日期间接受过疑似 COVID-19 检测的所有受试者的队列。检测结果、药物使用情况和合并症是从病历中获得的。在比较不同的倾向得分加权方法后，使用重叠倾向得分加权来分析药物使用与 COVID-19 诊断之间的关联。

结果

该队列包括 928 名患者，其中 12% 检测呈阳性。大多数 (66%) 患者有慢性肺部疾病病史。吸入皮质类固醇的使用与 COVID-19 检测呈阳性之间没有显着关联。有趣的是，全身使用皮质类固醇与较低的 COVID-19 检测阳性比值比（0.95，95% CI：0.91–0.99）相关。当分析仅限于患有任何慢性肺病、哮喘或慢性阻塞性肺病 (COPD) 的患者时，也出现了类似的结果。

结论

我们的研究支持以下建议，即需要吸入或全身性皮质类固醇治疗的慢性肺病患者（包括哮喘和慢性阻塞性肺病）应在 COVID-19 大流行期间继续使用。