Abstract
Background
It is unknown whether nasal (NCS) or inhaled corticosteroid (ICS) use impacts the susceptibility to SARS-CoV-2 infection.
Objectives
To examine the associations of NCS and ICS use with the risk of SARS-CoV-2 infection among individuals with allergic rhinitis or asthma.
Methods
This is a prospective, multicenter, SARS-CoV-2 surveillance study of households with children. Nasal swabs were obtained from participants every two weeks with additional collections based on COVID-19-related symptoms. In our primary adjusted models, we examined the association of NCS or ICS use at study entry (in participants with allergic rhinitis or asthma, respectively) with the time to the first SARS-CoV-2 positive quantitative PCR testing using Cox proportional hazard regression.
Results
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| Effect modification of age on the association of using topical airway corticosteroids (nasal [NCS] and inhaled [ICS] corticosteroids) with the risk of SARS-CoV-2 infection. |
There were 2,211 participants in 1,113 households included. The associations of NCS and ICS use with the risk of SARS-CoV-2 infection were modified by age (p for both interactions<0.05). NCS and ICS use were individually associated with higher risks of SARS-CoV-2 infection among adults (adjusted hazard ratio [aHR]=1.88, 95% CI=1.14-3.12, p=0.01, and aHR=2.15, 95% CI=1.003-4.63, p=0.049, respectively). The association of NCS use with the risk of SARS-CoV-2 infection in adults was consistent in a series of sensitivity analyses. There was no association of NCS or ICS use with the risk of SARS-CoV-2 infection in children.
Conclusions
Our findings suggest that the risk of SARS-CoV-2 infection is increased in adults who use NCS but not in children. Similar, albeit less consistent, age-dependent findings were observed for ICS use. While the results of this observational study should be interpreted with caution, they emphasize the need to conduct studies to understand potential mechanisms that could explain these findings.
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