ABSTRACT
BACKGROUND: There is conflicting evidence regarding the effect of asthma and its different therapeutic options on COVID-19 severity and the clinical outcomes. AIM: This study aimed to investigate the relationship between using inhaled corticosteroids (ICS) by asthmatic patients and the severity of COVID-19. MATERIALS AND METHODS: This retrospective observational study was conducted from March 15 to October 23, 2020 and included data of all COVID-19 asthmatic patients (nâ¯=â¯287) at King Abdulaziz Medical City. Twelve patients were excluded due to poor medication history documentation or using ICS for non-asthma indication. Ordinal logistic regression was used to determine the clinical variables that affect COVID-19 severity. The clinical outcomes of ICS and non-ICS users were compared. RESULTS: Of the sample (nâ¯=â¯275), 198 (72%) were using ICS therapy. No significant difference was found between ICS and non-ICS users in disease severity (Pâ¯=â¯0.12), mortality (Pâ¯=â¯0.45), ICU admission (Pâ¯=â¯0.78), and the occurrence of complications. However, the number of days on ventilation were significantly increased in ICS users (Pâ¯=â¯0.006). Being prescribed the ICS/LABA combination (adj OR: 0.72 [0.15,1.2]; Pâ¯=â¯0.021), being hypertensive (adj OR: 0.98 [0.28,1.6]; Pâ¯=â¯0.006), having cancer (adj OR: 1.49 [0.12, 2.8]; Pâ¯=â¯0.033), or having diabetes (adj OR: 0.75 [0.09, 1.4]; Pâ¯=â¯0.024) could not increase the risk for more severe disease. CONCLUSION: Overall, ICS therapy did not alter the COVID-19 severity or mortality in asthmatic patients. The continued use of ICS during the pandemic should be encouraged to prevent asthma exacerbations.