Association between inhaled corticosteroid use and SARS-CoV-2 infection: A nationwide population-based study in South Korea.

Background Inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, but its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is not known. This study aimed to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among the patients with chronic respiratory diseases. Methods The Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea provided nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15. The positivity of SARS-CoV-2 infection were retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test. Results Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among the types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. The multivariate analysis showed no significant increase in infection with ICS use (OR, 0.84; 95% CI, 0.66-1.03). Moreover, there were no associations between the positivity of infection, and doses or types of ICS prescribed. Conclusion Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect the positivity.