PDF(Pubmed)
Abstract：
Inhaled corticosteroids have been widely reported as a preventive measure against the development of severe forms of COVID-19 not only in patients with asthma.
In 654 Czech and Slovak patients with asthma who developed COVID-19, we investigated whether the correct use of inhaler containing corticosteroids was associated with a less severe course of COVID-19 and whether this had an impact on the need for hospitalisation, measurable lung functions and quality of life (QoL).
Of the studied cohort 51.4% had moderate persistent, 29.9% mild persistent and 7.2% severe persistent asthma. We found a significant adverse effect of poor inhaler adherence on COVID-19 severity (p=0.049). We also observed a lower hospitalisation rate in patients adequately taking the inhaler with OR of 0.83. Vital capacity and forced expiratory lung volume deterioration caused by COVID-19 were significantly reversed, by approximately twofold to threefold, in individuals who inhaled correctly.
Higher quality of inhalation technique of corticosteroids measured by adherence to an inhaled medication application technique (A-AppIT) score had a significant positive effect on reversal of the vital capacity and forced expiratory lung volume in 1 s worsening (p=0.027 and p<0.0001, respectively) due to COVID-19. Scoring higher in the A-AppIT was also associated with significantly improved QoL. All measured variables concordantly and without exception showed a positive improvement in response to better adherence. We suggest that corticosteroids provide protection against the worsening of lungs in patients with COVID-19 and that correct and easily assessable adherence to corticosteroids with appropriate inhalation technique play an important role in preventing severe form of COVID-19.
In 654 Czech and Slovak patients with asthma who developed COVID-19, we investigated whether the correct use of inhaler containing corticosteroids was associated with a less severe course of COVID-19 and whether this had an impact on the need for hospitalisation, measurable lung functions and quality of life (QoL).
Of the studied cohort 51.4% had moderate persistent, 29.9% mild persistent and 7.2% severe persistent asthma. We found a significant adverse effect of poor inhaler adherence on COVID-19 severity (p=0.049). We also observed a lower hospitalisation rate in patients adequately taking the inhaler with OR of 0.83. Vital capacity and forced expiratory lung volume deterioration caused by COVID-19 were significantly reversed, by approximately twofold to threefold, in individuals who inhaled correctly.
Higher quality of inhalation technique of corticosteroids measured by adherence to an inhaled medication application technique (A-AppIT) score had a significant positive effect on reversal of the vital capacity and forced expiratory lung volume in 1 s worsening (p=0.027 and p<0.0001, respectively) due to COVID-19. Scoring higher in the A-AppIT was also associated with significantly improved QoL. All measured variables concordantly and without exception showed a positive improvement in response to better adherence. We suggest that corticosteroids provide protection against the worsening of lungs in patients with COVID-19 and that correct and easily assessable adherence to corticosteroids with appropriate inhalation technique play an important role in preventing severe form of COVID-19.
摘要：
背景：吸入皮质类固醇不仅在哮喘患者中被广泛报道为预防严重形式COVID-19发展的预防措施。
方法：在654名发展为COVID-19的捷克和斯洛伐克哮喘患者中，我们调查了正确使用含糖皮质激素的吸入器是否与COVID-19的严重病程有关，以及这是否对住院需求产生影响，可测量的肺功能和生活质量(QoL)。
结果：在研究的队列中，51.4%的患者有中度持续性，29.9%轻度持续性哮喘和7.2%重度持续性哮喘。我们发现吸入器依从性差对COVID-19严重程度有显著的不利影响(p=0.049)。我们还观察到，充分服用吸入器的患者的住院率较低，OR为0.83。COVID-19引起的肺活量和用力呼气肺容积恶化明显逆转，大约两倍到三倍，正确吸入的人。
结论：通过坚持吸入药物应用技术（A-AppIT）评分来衡量的更高质量的皮质类固醇吸入技术对肺活量和用力呼气肺容量的逆转具有显着的积极作用由于COVID-19而恶化1s（分别为p=0.027和p<0.0001）。在A-AppIT中得分较高也与QoL的显着改善有关。所有测量的变量一致且毫无例外地显示出响应于更好的依从性的积极改善。我们建议皮质类固醇对COVID-19患者的肺部恶化提供保护，并且通过适当的吸入技术正确且易于评估的对皮质类固醇的依从性在预防严重形式的COVID-19中起着重要作用。
方法：在654名发展为COVID-19的捷克和斯洛伐克哮喘患者中，我们调查了正确使用含糖皮质激素的吸入器是否与COVID-19的严重病程有关，以及这是否对住院需求产生影响，可测量的肺功能和生活质量(QoL)。
结果：在研究的队列中，51.4%的患者有中度持续性，29.9%轻度持续性哮喘和7.2%重度持续性哮喘。我们发现吸入器依从性差对COVID-19严重程度有显著的不利影响(p=0.049)。我们还观察到，充分服用吸入器的患者的住院率较低，OR为0.83。COVID-19引起的肺活量和用力呼气肺容积恶化明显逆转，大约两倍到三倍，正确吸入的人。
结论：通过坚持吸入药物应用技术（A-AppIT）评分来衡量的更高质量的皮质类固醇吸入技术对肺活量和用力呼气肺容量的逆转具有显着的积极作用由于COVID-19而恶化1s（分别为p=0.027和p<0.0001）。在A-AppIT中得分较高也与QoL的显着改善有关。所有测量的变量一致且毫无例外地显示出响应于更好的依从性的积极改善。我们建议皮质类固醇对COVID-19患者的肺部恶化提供保护，并且通过适当的吸入技术正确且易于评估的对皮质类固醇的依从性在预防严重形式的COVID-19中起着重要作用。
