Chronic use of inhaled corticosteroids in patients admitted for respiratory virus infections: a 6-year prospective multicenter study
Authors: 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 ,   the FLUVAC Study Group, Launay O. , Lenzi N. , Lesieur Z. , Loulergue P. , Momcilovic S. , Mira J. P. , Marin N. , Charpentier J. , Regent A. , Kanaan R. , Dumas F. , Doumenc B. , L’Honneur A. S. , Lachatre M. , Szwebel T. , Kansao J. , Costa Y. , Duval X. , Alexandra J. F. , 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  , Descamps V. , Dieude P. , Dossier A. , Douron N. , Dupeyrat E. , Emeyrat N. , Fernet C. , Goulenok T. , Harent S. , Jouenne R. , Justet A. , Lachatre M. , 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  , Ralainnazava P. , Ranaivoision M. , Raynaud-Simon A. , Rioux C. , Sacre K. , Verry V. , Vuong V. , Yazdapanah Y. , Houhou N. , Galtier F. , Géraud P. , Driss V. , Maugueret V. , Crantelle L. , Agostini C. , Ray M. , Letois F. , Mura T. , Serrand C. , Agostini C. , Noslier S. , Giordano A. , Chevassus H. , Nyiramigisha E. , Merle C. , Bourdin A. , Konaté A. , Capdevilla X. , Du Cailar G. , Terminet A. , Blain H. , Leglise M. S. , Le Quellec A. , Corne P. , Landreau L. , Klouche K. , Bourgeois A. , Sebbane M. , Mourad G. , Leray H. , Foulongne V. , Postil D. , Alcolea S. , Couve-Deacon E. , Rogez S. , Amour S. , Vanhems P. , Argaud L. , Cour M. , Hernu R. , Simon M. , Baudry T. , Tazarourte K. , Bui-Xuan C. , Fattoum J. , Lina B. , Valette M. , Lainé F. , Thibault V. , Rochas S. , Cochennec S. , Thébault E. , Lagathu G. , Jouneau S. , Revest M. , Bénézit F. , Sébillotte M. , Le Bot A. , Baldeyrou M. , Patrat-Delon S. , Cailleaux M. , Pronier C. , Tattevin P. 
Published: March 2022

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.