Chronic use of inhaled corticosteroids in patients admitted for respiratory virus infections: a 6-year prospective multicenter study

• Published in: Scientific reports Vol. 12; no. 1; p. 4199
• Main Authors: Luque-Paz, David, Tattevin, Pierre, Loubet, Paul, Bénézit, François, Thibault, Vincent, Lainé, Fabrice, Vanhems, Philippe, Amour, Selilah, Lina, Bruno, Duval, Xavier, L’Honneur, Anne-Sophie, Fidouh, Nadhira, Vallejo, Christine, Alain, Sophie, Galtier, Florence, Foulongne, Vincent, Lagathu, Gisèle, Lenzi, Nezha, Lesieur, Zineb, Launay, Odile, Jouneau, Stéphane
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 10.03.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/326/2521; 631/326/596; 692/499; Adenoviruses; Bronchus; Corticoids; Corticosteroids; Human health and pathology; Humanities and Social Sciences; Infections; Infectious diseases; Influenza; Life Sciences; multidisciplinary; Patients; Pneumonia; Pulmonology and respiratory tract; Regression analysis; Respiratory syncytial virus; Risk factors; Science; Science (multidisciplinary); Steroids; Viruses
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-08089-0

Inhaled corticosteroids (ICS) have been associated with increased risk of pneumonia. Their impact on respiratory virus infections is unclear. We performed a post-hoc analysis of the FLUVAC cohort, a multicenter prospective cohort study of adults hospitalized with influenza-like illness (ILI) during six consecutive influenza seasons (2012–2018). All patients were tested for respiratory virus infection by multiplex PCR on nasopharyngeal swabs and/or bronchoalveolar lavage. Risk factors were identified by logistic regression analysis. Among the 2658 patients included, 537 (20.2%) were treated with ICS before admission, of whom 282 (52.5%, 282/537) tested positive for at least one respiratory virus. Patients on ICS were more likely to test positive for non-influenza respiratory viruses (25.1% vs. 19.5%, P  = 0.004), especially for adenovirus (aOR 2.36, 95% CI 1.18–4.58), and respiratory syncytial virus (aOR 2.08, 95% CI 1.39–3.09). Complications were reported in 55.9% of patients on ICS (300/537), primarily pneumonia (171/535, 32%). Among patients on chronic ICS who tested positive for respiratory virus, 14.2% (40/282) were admitted to intensive care unit, and in-hospital mortality rate was 2.8% (8/282). Chronic use of ICS is associated with an increased risk of adenovirus or RSV infections in patients admitted for ILI.