Inhaled corticosteroids for the treatment of COVID-19

Evidence from clinical studies indicates that inhaled corticosteroids (ICS) taken routinely for asthma and COPD may have had a protective role in preventing severe COVID-19 and, therefore, may be a promising treatment for COVID-19. This review summarizes the evidence supporting the beneficial effects of ICS on outcomes in patients with COVID-19 and explores potential protective mechanisms.

It appears that the more severe and symptomatic initial COVID-19 infection is associated with an increased likelihood of suffering COVID-19 sequelae – “long COVID”, although further studies are needed. ICS can benefit patients with early symptoms by acting on the inflammation evident at the start of infection and inhibiting viral replication. Treating the infection as early as possible reduces the incidence of these sequelae. Based on observations of the positive effects of ICS in COVID-19 studies to date, it is possible that they may have a beneficial effect on long-term respiratory outcomes, as well as on impaired lung function associated with COVID-19 sequelae, which merits further investigation.

In conclusion, ICS could benefit patients infected with COVID-19, particularly high-risk groups, if ideally used within days of symptom onset. As the side effects of ICS are well known and reversible on discontinuation of treatment, their favorable benefit/risk profile suggests that ICS are an attractive option for the treatment of COVID-19.

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Mona Bafadhel, Rosa Faner, Camille Taillé, Richard E. K. Russell, Tobias Welte, Peter J. Barnes, Alvar Agustí
European Respiratory Review 2022 31: 220099; DOI: 10. 1183/16000617. 0099-2022