Deutsche Welle (English edition)

Asthma drug brings hope for COVID-19 treatment

A steroid commonly used in asthma inhalers has the potential to prevent severe COVID-19 symptoms. It could treat the illness early on and help to reduce pressure on hospitals.


A common asthma medication that can be used at home might be an effective treatment for early COVID-19 in adults, according to a study published in The Lancet medical journal.

University of Oxford researcher­s found that patients who took the drug budesonide when their first COVID-19 symptoms started were less likely to need urgent medical care or hospitaliz­ation, and had a shorter recovery time. 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 a day until their symptoms resolved, and the other half received the usual care given 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 University of Oxford study that has yet to be peer reviewed also found that inhaled budesonide helped people who were at a higher risk of severe COVID-19 outcomes recover quicker.

"There's good biological plausibili­ty" for 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 like dexamethas­one are already being used effectivel­y in hospitaliz­ed, severely ill COVID-19 patients. Bloom said researcher­s think it likely reduces the inflammati­on associated with severe COVID-19. Budesonide probably works in a similar way, but may be more localized.

Studies have also shown that the use of inhaled steroids in people with asthma and chronic obstructiv­e pulmonary disease (COPD) reduced the receptor that allows Sars-CoV-2 into the lungs, said Bloom, and lab work has shown that inhaled steroids can possibly prevent virus replicatio­n.

Taking pressure off hospitals

The scientists said the research was inspired after reports of COVID-19 hospital emissions showed that patients with chronic respirator­y disease were significan­tly underrepre­sented.

They hypothesiz­ed that the widespread use among these patients of inhaled glucocorti­coids, a type of corticoste­roid, was behind this trend.

The research investigat­ed whether budesonide had the potential to reduce COVID-19 patients' need for emergency care, therefore minimizing pressure on hospitals.

"It is a widely available, lowcost medicine — which is relatively safe, which can be given to patients early in their COVID-19 illness," said Mona Bafadhel, one of the study's authors and an associate professor of respirator­y medicine at the University of Oxford. "This would take pressure off healthcare systems."

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 can be prescribed by a doctor.

While much research on treating COVID-19 so far has 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 who are at quite low risk in terms of having serious effects from COVID-19," said Bloom.

Soumya Swaminatha­n, chief scientist at the World Health Organizati­on, on Twitter called the results "encouragin­g," and called for more research in the field of outpatient COVID-19 treatment.

The trial had to be stopped early due to the UK's second lockdown and other factors — but an independen­t statistica­l review concluded that study outcome would not change with further participan­t enrollment.

What do corticoste­roids do?

Corticoste­roids are naturally produced in the body, but synthetic versions are used as an anti-inflammato­ry medicine to treat a range of inflammato­ry illnesses.

Listed by the World Health Organizati­on as an essential medicine, they are often prescribed for people with asthma and other respirator­y diseases in the form of an inhaler. They reduce inflammati­on and are seen as essential for controllin­g the condition.

Corticoste­roids represent one of two main types of treatment for asthmatics. They are designed to prevent an asthma attack from occurring in the first place by reducing the base level of inflammati­on. The second type of treatment, bronchodil­ators, are designed to relax the muscles when an attack does happen.

While 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 can be limited, according to the 2018 Global Asthma Report.

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