A common asthma medication that can be used at home may be an effective treatment for early COVID-19 in adults, according to a study published in The Lancet medical journal.
Researchers at Oxford University found that patients who took the drug budesonide when they began their first symptoms of COVID-19 were less likely to need urgent medical attention or hospitalization and had a shorter recovery time. It also reduced the chance of persistent symptoms and fever.
The randomized controlled trial involved 146 adults seven days after the onset of mild COVID-19 symptoms. Half of the participants inhaled budesonide twice a day until symptoms resolved and the other half received regular care based on age, gender, and existing illnesses.
In the budesonide group, only one person needed urgent medical attention, compared to the 10 people in the group who received standard COVID-19 care.
Another Oxford University study that has not yet been peer-reviewed also found that inhaled budesonide helped people at higher risk of severe COVID-19 outcomes recover faster.
“There’s a good biological likelihood” why corticosteroids would work, Chloe Bloom, a senior clinical researcher at the National Institute of Heart and Lung at Imperial College London, told DW. Bloom did not participate in the study.
Corticosteroids such as dexamethasone are already used effectively in hospitalized and severe COVID-19 patients. Bloom said researchers think it probably reduces the inflammation associated with severe COVID-19. Budesonide probably works similarly, but may be more localized.
Studies have also shown that the use of inhaled steroids in people with asthma and chronic obstructive pulmonary disease (COPD) reduces the receptor that allows Sars-CoV-2 to enter the lungs, according to Bloom, and laboratory work has shown that inhaled steroids can possibly prevent replication of the virus.
Take pressure off hospitals
The scientists said the research was inspired after reports of hospital releases of COVID-19 showed that patients with chronic respiratory disease were significantly underrepresented.
They hypothesized that the widespread use of these patients for inhaled glucocorticoids, a type of corticosteroid, was behind this trend.
The research investigated whether budesonide had the potential to reduce the need for emergency care for patients with COVID-19, thereby reducing the pressure on hospitals.
“It is a low-cost, widely available drug that is relatively safe that can be administered to patients early in their COVID-19 disease,” said Mona Bafadhel, one of the study’s authors and associate professor of respiratory medicine at Oxford University. “This would remove pressure from health systems.”
Karl Lauterbach, a Social Democrat member of parliament and a German epidemiologist, said on Twitter that the study changed the game, in part because it identifies a possible early COVID-19 treatment that may be prescribed by a doctor.
Although much research on the treatment of COVID-19 has so far focused on patients who already have severe symptoms, this trial shows potential for prior intervention.
“What’s unique about this trial is that it also looks at people at a fairly low risk in terms of having serious effects of COVID-19,” Bloom said.
Soumya Swaminathan, chief scientist at the World Health Organization, on Twitter described the results as “encouraging” and called for more research in the field of outpatient COVID-19 treatment.
The trial had to be stopped early due to the second UK blockade and other factors, but an independent statistical review concluded that the outcome of the study would not change with the enrollment of new participants.
What do corticosteroids do?
Corticosteroids are produced naturally in the body, but synthetic versions are used as an anti-inflammatory drug to treat various inflammatory diseases.
Listed by the World Health Organization as essential drugs, they are often prescribed to people with asthma and other respiratory illnesses in the form of an inhaler. They reduce inflammation and are considered essential for controlling the disease.
Corticosteroids represent one of the two main types of treatment for asthmatics. They are designed to prevent an asthma attack from occurring in the first place by reducing the basic level of inflammation. The second type of treatment, bronchodilators, are designed to relax muscles when an attack occurs.
Although corticosteroids are available and cheap in some parts of the world, this is not always the case in low- and middle-income countries, where access to these drugs may be limited, according to the 2018 Global Asthma Report. .
