定期使用吸入性皮质类固醇可能会防止COPD中严重的COVID-19结果
Marina Labor1, Brian K Kirui2, Fredrik Nyberg2
1Cancer and Lung Health Care Unit, University Hospital in Linköping, Linköping, Sweden.
International journal of chronic obstructive pulmonary disease
|August 14, 2023
概括
吸入性皮质类固醇 (ICS) 并没有增加COPD患者的COVID-19风险. 然而,ICS疗法保护了住院的COPD患者免受ICU入院和死亡等严重后果,支持持续使用.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 关于COPD患者吸入性皮质类固醇 (ICS) 和COVID-19的结果,存在相互矛盾的证据.
- 调查常规ICS使用对SARS-CoV-2感染风险,严重程度和生存的影响至关重要.
研究的目的:
- 确定定期吸入性皮质类固醇 (ICS) 暴露是否会影响COPD患者的SARS-CoV-2感染风险,严重程度或存活率.
- 为了澄清ICS使用和COVID-19结果之间的关联,使用全国性的瑞典人口数据.
主要方法:
- 使用了瑞典全国人口登记数据库,包括超过520万个人 (≥40岁) 和133,372名COPD患者.
- 考克斯回归和倾向得分方法 (ATT权重) 用于估计COVID-19发病,住院,ICU入院和死亡的危险比率.
- 分析了三个队列:整体,COVID-19诊断和COVID-19住院,常规ICS使用定义为前一年≥3处方.
主要成果:
- 定期使用ICS在一般和COPD人群中与增加COVID-19发病,住院或死亡的相关性很小.
- 在被诊断为COVID-19的子队伍中没有明显的风险增加.
- 在住院的COPD患者中,ICS治疗与ICU入院的风险降低和死亡风险显著降低有关 (HR 0.82).
结论:
- 吸入性皮质类固醇 (ICS) 疗法似乎可以防止严重的COVID-19进展,特别是减少住院COPD患者的ICU入院和死亡风险.
- 这些发现减轻了人们对ICS治疗可能增加的COVID-19风险的担忧.
- 证据支持继续使用ICS治疗来治疗COPD患者,即使是在COVID-19大流行期间.
相关概念视频
COPD: Management Using Bronchodilators and Corticosteroids
244
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
244
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
299
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
299
Inhaled Medications
309
Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
309
Drugs Used in Lower Respiratory Disorders: Overview
489
Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
489
COPD: Pathogenesis and Clinical Features
344
Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that progressively worsen over time, including chronic bronchitis and emphysema. This cluster of diseases collectively leads to a gradual and irreversible decline in lung function over time.
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
344
Chronic Obstructive Pulmonary Disease-V: Management
2.6K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.6K


