A common asthma medication that can be used at home is an effective treatment for early COVID-19 in adults, according to a study published in The Lancet medical journal.
Oxford University researchers found that patients who took the drug budesonide when their first COVID-19 symptoms started were less likely to require urgent medical attention or hospitalization, and that they had shorter recovery times. It also reduced the chance of persistent symptoms and fever.
The randomized controlled trial involved 146 adults within seven days of the onset of mild COVID-19 symptoms. Half of the participants inhaled budesonide twice daily until their symptoms disappeared, and the other half received normal care based on age, gender, and existing illnesses.
In the budesonide group, only one person needed urgent medical care, compared to 10 people in the group who received the standard care for COVID-19.
Another study from Oxford University that had not yet been peer-reviewed also found that inhaled budesonide helped people who were at higher risk for severe COVID-19 outcomes recover faster.
‘There is good biological plausibility’ why corticosteroids would work, Chloe Bloom, a senior clinical research fellow at Imperial College London’s National Heart and Lung Institute, told DW. Bloom was not involved in the study.
Corticosteroids such as dexamethasone are already being used effectively in COVID-19 patients admitted to the hospital. Bloom said researchers think it is likely to reduce the inflammation associated with severe COVID-19. Budesonide probably works in a similar way, but is perhaps 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 Sars-CoV-2 allows in the lungs, Bloom said. Laboratory work has shown that inhaled steroids can potentially prevent virus replication.
Pressure from hospitals decreases
According to the scientists, the research was inspired after reports of COVID-19 hospital releases showed that patients with chronic respiratory diseases were significantly underrepresented.
They hypothesized that the general use of these inhaled glucocorticoids, a type of corticosteroid, was behind this trend.
The research investigated whether budesonide has the potential to reduce the need for COVID-19 patients for emergency care, thus minimizing the pressure on hospitals.
“It is a widely available, inexpensive drug – relatively safe, that can be given to patients early in their COVID-19 disease,” said Mona Bafadhel, one of the study’s authors and associate professor of respiratory medicine. University of Oxford. “It will put health care systems under pressure.”
Karl Lauterbach, a Social Democrat member of the German parliament and epidemiologist, said on Twitter that the study was a ‘game changer’, in part because it identifies a potential early COVID-19 treatment that a doctor may prescribe word.
While much research on COVID-19 treatment has so far focused on patients who already have severe symptoms, this trial shows potential for earlier intervention.
“What is unique about this trial is that it also looks at people at a fairly low risk of having COVID-19,” Bloom said.
Soumya Swaminathan, chief scientist at the World Health Organization, called the results “encouraging” on Twitter and called for more research in the field of outpatient treatment COVID-19.
The trial had to be stopped early due to the second exclusion from the UK and other factors, but an independent statistical review concluded that the outcome of the study would not change with further entries from participants.
What do corticosteroids do?
Corticosteroids are naturally produced in the body, but synthetic versions are used as an anti-inflammatory agent to treat a range of inflammatory diseases.
Listed by the World Health Organization as an essential medicine, it is often prescribed for people with asthma and other respiratory diseases in the form of an inhaler. It reduces inflammation and is considered essential to control the condition.
Corticosteroids are one of the two main types of treatment for asthma. It is designed to prevent an asthma attack in the first place by lowering the base level of inflammation. The second type of treatment, bronchodilators, is designed to relax the muscles when an attack occurs.
Although corticosteroids are readily available and inexpensive in some parts of the world, this is not always the case for low- and middle-income countries, where access to such drugs may be restricted, according to the 2018 Global Asthma Report.
