Chronic use of inhaled corticosteroids in patients admitted for respiratory virus infections: a 6-year prospective multicenter study

David Luque-Paz (1, 2) , Pierre Tattevin (1, 2, 3) , Paul Loubet (4, 5, 6) , François Bénézit (1) , Vincent Thibault (1) , Fabrice Lainé (3, 1, 6) , Philippe Vanhems (7, 8) , Selilah Amour (7) , Bruno Lina (7) , Xavier Duval (6, 9) , Anne-Sophie L’honneur (10) , Nadhira Fidouh (11) , Christine Vallejo (12) , Sophie Alain (13) , Florence Galtier (14) , Vincent Foulongne (15) , Gisèle Lagathu (1) , Nezha Lenzi (6) , Zineb Lesieur (6) , Odile Launay (16) , Stéphane Jouneau (1, 17) , P. Loulergue , S. Momcilovic , J. Mira , N. Marin , J. Charpentier , A. Regent , R. Kanaan , F. Dumas , B. Doumenc , M. Lachatre , T. Szwebel , J. Kansao , Y. Costa , J. Alexandra , H. Becheur , K. Belghalem , J. Bernard , A. Bleibtreu , M. Boisseau , R. Bories , O. Brugiere , F. Brunet , C. Burdet , E. Casalino , M. Caseris , C. Chansiaux , M. Chauchard , P. Chavance , C. Choquet , A. Cloppet-Fontaine , L. Colosi , B. Couset , B. Crestani , F. Crocket , A. Debit , K Delanoe , V. Descamps , P. Dieude , A. Dossier , N. Douron , E. Dupeyrat , N. Emeyrat , C. Fernet , T. Goulenok , S. Harent , R. Jouenne , A. Justet , A. Leleu , I. Lerat , M. Lilamand , H. Mal , A. Marceau , A.-C. Metivier , K. Oplelatora , T. Papo , A.-L. Pelletier , L. Pereira , P. Pradere , R Prommier , P. Ralainnazava , M. Ranaivoision , A. Raynaud-Simon , C. Rioux , K. Sacre , V. Verry , V. Vuong , Y. Yazdapanah , N. Houhou , P. Géraud , V. Driss , V. Maugueret , L. Crantelle , C. Agostini , M. Ray , F. Letois , T. Mura , C. Serrand , S. Noslier , A. Giordano , H. Chevassus , E. Nyiramigisha , C. Merle , A. Bourdin (18, 19) , A. Konaté , X. Capdevilla , G. Du Cailar , A. Terminet , H. Blain , M. Leglise , A. Le Quellec , P. Corne , L. Landreau , K. Klouche (18, 19) , A. Bourgeois , M. Sebbane , G. Mourad , H. Leray , D. Postil , S. Alcolea , E. Couve-Deacon , S. Rogez , L. Argaud , M. Cour , R. Hernu , M. Simon , T. Baudry , K. Tazarourte , C. Bui-Xuan , J. Fattoum , M. Valette , S. Rochas , S. Cochennec , E. Thébault , M. Revest , M. Sébillotte , A. Le Bot , M. Baldeyrou , S. Patrat-Delon , M. Cailleaux , C. Pronier

1 CHU Pontchaillou [Rennes]
2 BRM - ARN régulateurs bactériens et médecine
3 CIC - Centre d'Investigation Clinique [Rennes]
4 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
5 VBIC - Virulence Bactérienne et Infections Chroniques
6 F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC)
7 HCL - Hospices Civils de Lyon
8 CIRI - Centre International de Recherche en Infectiologie - UMR
9 CIC - CHU Bichat
10 Hôpital Cochin [AP-HP]
11 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
12 CIC1435 - Centre d'Investigation Clinique de Limoges
13 RESINFIT - Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
14 CIC Montpellier
15 CHU Montpellier
16 CIC 1417 - CIC Cochin Pasteur
17 Irset - Institut de recherche en santé, environnement et travail
18 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
19 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]

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.

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Human health and pathology; Infectious diseases; Life Sciences [q-bio]; Human health and pathology; Pulmonology and respiratory tract

David Luque-Paz, Pierre Tattevin, Paul Loubet, François Bénézit, Vincent Thibault, et al.. Chronic use of inhaled corticosteroids in patients admitted for respiratory virus infections: a 6-year prospective multicenter study. Scientific Reports, 2022, 12 (1), pp.4199. ⟨10.1038/s41598-022-08089-0⟩. ⟨hal-03607627⟩