key: cord-0869967-e5h8my0z
authors: Valentin, S.; Basin, S.; Chaouat, A.
title: Response to letter to the editor: Progression to a severe form of COVID-19 among patients with chronic respiratory diseases Reply to Antoine Ausset and Monica Pop
date: 2022-03-15
journal: Respir Med Res
DOI: 10.1016/j.resmer.2022.100902
sha: 9e9d5ebc4dfc7ff5c20b13544c044d954961d9e5
doc_id: 869967
cord_uid: e5h8my0z

nan

Response to letter to the editor: Progression to a severe form of COVID-19 among patients with chronic respiratory diseases

Authors: S. Valentin (1, 2) , S. Basin (1) , A. Chaouat (1, 2) Affiliations :

1 Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France.

2 Université de Lorraine, Faculté de Médecine de Nancy, Inserm UMR_S1116, Vandoeuvre-Lès-Nancy, France.

Dear Editor, we appreciate Ausset et al., consideration of our study in their letter reminding us of the very recent literature related to a protective role of chronic respiratory diseases, especially asthma and chronic obstructive pulmonary disease. As stated in the letter, the meta-analysis by Rogliani et al., included 8476 hospitalized patients for SARS-CoV-2 infection and found that patients with asthma and chronic obstructive pulmonary disease (COPD) were at reduced risk of hospitalization [1] . Another meta-analysis showed opposite results [2] . These data should be interpreted with great caution as they do not consider the severity of the underlying respiratory disease. Indeed and as well explained in the letter by and revealed that ICS improved time to recovery [4] . A recent meta-analysis supported the benefit of ICS in resolving clinical symptoms in non-hospitalized patients with COVID-19 [5] .

In contrast, in a post-hoc analysis of over 8 million patients, two or more prescriptions of ICS led to a slightly higher risk of severe COVID-19 [6] . [7] . However, the clinical relevance of these in vitro findings remains to be clarified.

In conclusion, on the one hand, asthma and COPD seem to protect against COVID-19 depending on the severity of the underlying chronic respiratory disease. On the other hand, ICS could have a protective role but only the results of ongoing randomized controlled trials will confirm this hypothesis.

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Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19)

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Inhaled budesonide for COVID-19 in people at high risk of complications in the community in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial

Inhaled corticosteroids for outpatients with Covid-19: a meta-analysis

Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study

Inhaled corticosteroids downregulate SARS-CoV-2-related genes in COPD: results from a randomised controlled trial