Chronic use of inhaled corticosteroids in patients admitted for respiratory virus infections: a 6-year prospective multicenter study
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Luque-Paz, David | Tattevin, Pierre | Loubet, Paul | Bénézit, François | Thibault, Vincent | Lainé, Fabrice | Vanhems, Philippe | Amour, Selilah | Lina, Bruno | Duval, Xavier | L’honneur, Anne-Sophie | Fidouh, Nadhira | Vallejo, Christine | Alain, Sophie | Galtier, Florence | Foulongne, Vincent | Lagathu, Gisèle | Lenzi, Nezha | Lesieur, Zineb | Launay, Odile | Jouneau, Stéphane | Loulergue, P. | Momcilovic, S. | Mira, J. | Marin, N. | Charpentier, J. | Regent, A. | Kanaan, R. | Dumas, F. | Doumenc, B. | Lachatre, M. | Szwebel, T. | Kansao, J. | Costa, Y. | Alexandra, J. | Becheur, H. | Belghalem, K. | Bernard, J. | Bleibtreu, A. | Boisseau, M. | Bories, R. | Brugiere, O. | Brunet, F. | Burdet, C. | Casalino, E. | Caseris, M. | Chansiaux, C. | Chauchard, M. | Chavance, P. | Choquet, C. | Cloppet-Fontaine, A. | Colosi, L. | Couset, B. | Crestani, B. | Crocket, F. | Debit, A. | Delanoe, K | Descamps, V. | Dieude, P. | Dossier, A. | Douron, N. | Dupeyrat, E. | Emeyrat, N. | Fernet, C. | Goulenok, T. | Harent, S. | Jouenne, R. | Justet, A. | Leleu, A. | Lerat, I. | Lilamand, M. | Mal, H. | Marceau, A. | Metivier, A.-C. | Oplelatora, K. | Papo, T. | Pelletier, A.-L. | Pereira, L. | Pradere, P. | Prommier, R | Ralainnazava, P. | Ranaivoision, M. | Raynaud-Simon, A. | Rioux, C. | Sacre, K. | Verry, V. | Vuong, V. | Yazdapanah, Y. | Houhou, N. | Géraud, P. | Driss, V. | Maugueret, V. | Crantelle, L. | Agostini, C. | Ray, M. | Letois, F. | Mura, T. | Serrand, C. | Noslier, S. | Giordano, A. | Chevassus, H. | Nyiramigisha, E. | Merle, C. | Bourdin, Arnaud | Konaté, A. | Capdevilla, X. | Du Cailar, G. | Terminet, A. | Blain, H. | Leglise, M. | Le Quellec, A. | Corne, P. | Landreau, L. | Klouche, K. | Bourgeois, A. | Sebbane, M. | Mourad, G. | Leray, H. | Postil, D. | Alcolea, S. | Couve-Deacon, E. | Rogez, S. | Argaud, L. | Cour, M. | Hernu, R. | Simon, M. | Baudry, T. | Tazarourte, K. | Bui-Xuan, C. | Fattoum, J. | Valette, M. | Rochas, S. | Cochennec, S. | Thébault, E. | Revest, M. | Sébillotte, M. | Le Bot, A. | Baldeyrou, M. | Patrat-Delon, S. | Cailleaux, M. | Pronier, C.
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Inhaled corticosteroids (ICS) have been associated with increased risk of pneumonia. Their impact on respiratory virus infections is unclear. We performed a post-hoc analysis of the FLUVAC cohort, a multicenter prospective cohort study of adults hospitalized with influenza-like illness (ILI) during six consecutive influenza seasons (2012–2018). All patients were tested for respiratory virus infection by multiplex PCR on nasopharyngeal swabs and/or bronchoalveolar lavage. Risk factors were identified by logistic regression analysis. Among the 2658 patients included, 537 (20.2%) were treated with ICS before admission, of whom 282 (52.5%, 282/537) tested positive for at least one respiratory virus. Patients on ICS were more likely to test positive for non-influenza respiratory viruses (25.1% vs. 19.5%, P = 0.004), especially for adenovirus (aOR 2.36, 95% CI 1.18–4.58), and respiratory syncytial virus (aOR 2.08, 95% CI 1.39–3.09). Complications were reported in 55.9% of patients on ICS (300/537), primarily pneumonia (171/535, 32%). Among patients on chronic ICS who tested positive for respiratory virus, 14.2% (40/282) were admitted to intensive care unit, and in-hospital mortality rate was 2.8% (8/282). Chronic use of ICS is associated with an increased risk of adenovirus or RSV infections in patients admitted for ILI.
