Impact of nasal and inhaled corticosteroids on SARS-CoV-2 infection susceptibility.
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Rosas-Salazar Christian, Gebretsadik Tebeb, Seibold Max A, Moore Camille M, Arbes Samuel J, Bacharier Leonard B, Brunwasser Steven M, Camargo Carlos A, Dupont William D, Furuta Glenn T, Gruchalla Rebecca S, Gupta Ruchi S, Jackson Daniel J, Johnson Christine C, Kattan Meyer, Khurana Hershey Gurjit K, Liu Andrew H, O'Connor George T, Phipatanakul Wanda, Ramratnam Sima K, Rothenberg Marc E, Sajuthi Satria P, Sanders Joshua, Seroogy Christine M, Snyder Brittney M, Stelzig Lia, Teach Stephen J, Zoratti Edward M, Togias Alkis, Fulkerson Patricia C, Hartert Tina V, HEROS Study Group
Аннотация
OBJECTIVES: We sought to examine the associations of NCS and ICS use with the risk of SARS-CoV-2 infection among individuals with allergic rhinitis or asthma.
METHODS: This is a prospective, multicenter, SARS-CoV-2 surveillance study of households with children. Nasal swabs were obtained from participants every 2 weeks with additional collections based on coronavirus disease 2019-related symptoms. In our primary adjusted models, we examined the association of NCS or ICS use at study entry (in participants with allergic rhinitis or asthma, respectively) with the time to the first SARS-CoV-2-positive quantitative PCR testing using Cox proportional hazard regression.
RESULTS: There were 2211 participants in the 1113 households included. The associations of NCS and ICS use with the risk of SARS-CoV-2 infection were modified by age (P for both interactions <.05). NCS and ICS use were individually associated with higher risks of SARS-CoV-2 infection among adults (adjusted hazard ratio [aHR] = 1.88, 95% CI: 1.14-3.12, P = .01, and aHR = 2.15, 95% CI: 1.003-4.63, P = .049, respectively). The association of NCS use with the risk of SARS-CoV-2 infection in adults was consistent in a series of sensitivity analyses. There was no association of NCS or ICS use with the risk of SARS-CoV-2 infection in children.
CONCLUSION: Our findings suggest that the risk of SARS-CoV-2 infection is increased in adults who use NCS but not in children. Similar, albeit less consistent, age-dependent findings were observed for ICS use. While the results of this observational study should be interpreted with caution, they emphasize the need to conduct studies to understand potential mechanisms that could explain these findings.