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BMC Pulm Med
. 2022 Sep 28;22(1):368.
doi: 10.1186/s12890-022-02168-8.
Clinical benefits of inhaled ciclesonide for hospitalized patients with COVID-19 infection: a retrospective study
Kuan-Chih Kuo # 1 2 , Chao-Hsien Chen # 1 2 , Chieh-Jen Wang 3 4 , Jou-Chun Wu 1 2 , Hsin-Pei Chung 1 2 , Yen-Ting Chen 1 2 , Yen-Hsiang Tang 2 5 , Wen-Kuei Chang 1 2 , Chang-Yi Lin 1 2 , Chien-Liang Wu 1
Affiliations
- PMID: 36171597
- DOI: 10.1186/s12890-022-02168-8
Abstract
Background: The successful management of patients infected with coronavirus disease 2019 (COVID-19) with inhaled ciclesonide has been reported, however few studies have investigated its application among hospitalized patients.
Methods: This retrospective cohort study enrolled all adult patients admitted to our hospital with confirmed COVID-19 infection from May to June 2021. Critical patients who received mechanical ventilation within 24 h after admission and those who started ciclesonide more than 14 days after symptom onset were excluded. The in-hospital mortality rate was compared between those who did and did not receive inhaled ciclesonide.
Results: A total of 269 patients were enrolled, of whom 184 received inhaled ciclesonide and 85 did not. The use of ciclesonide was associated with lower in-hospital mortality (7.6% vs. 23.5%, p = 0.0003) and a trend of shorter hospital stay (12.0 (10.0-18.0) days vs. 13.0 (10.0-25.3) days, p = 0.0577). In subgroup analysis, the use of inhaled ciclesonide significantly reduced mortality in the patients with severe COVID-19 infection (6.8% vs. 50.0%, p < 0.0001) and in those with a high risk of mortality (16.4% vs. 43.2%, p = 0.0037). The use of inhaled ciclesonide also reduced the likelihood of receiving mechanical ventilation in the patients with severe COVID-19 infection. After multivariate analysis, inhaled ciclesonide remained positively correlated with a lower risk of in-hospital mortality (odds ratio: 0.2724, 95% confidence interval: 0.087-0.8763, p = 0.0291).
Conclusions: The use of inhaled ciclesonide in hospitalized patients with COVID-19 infection can reduce in-hospital mortality. Further randomized studies in patients with moderate to severe COVID-19 infection are urgently needed.
Keywords: COVID-19; Ciclesonide; Inhaled corticosteroid; Mortality; SARS-CoV2.