30-day mortality and morbidity in COVID-19 versus influenza: A population- based study

Nersesjan, Vardan; Amiri, Moshgan; Christensen, Hanne; Benros, Michael E.; Kondziella, Daniel

doi:10.1101/2020.07.25.20162156

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…The finding of no effect of inhaled corticosteroids on influenza was consistent with a meta-analysis on randomized controlled trials of inhaled corticosteroid treatment(17). Furthermore, in parallel with other reports we found COVID-19 to be associated with a markedly higher level of overall morbidity and mortality compared with influenza(21,22). This finding underscores the severity of COVID-19, since our COVID-19 cohort was both younger and generally healthier than our influenza cohort was.…”

Section: Discussionsupporting

confidence: 91%

Inhaled corticosteroid use in COVID-19

Husby

Pottegaard

Hviid

2020

Preprint

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Background Recent evidence has established a beneficial effect of systemic corticosteroids for treatment of moderate-to-severe COVID-19. However, it is unknown if inhaled corticosteroid use is associated with reduced morbidity of the disease. Methods In a nationwide cohort of hospitalized SARS-CoV-2 test-positive individuals in Denmark, we estimated the 30-day hazard ratio of intensive care unit (ICU) admission or death among users of inhaled corticosteroids (ICS) compared with users of non-ICS inhalers (β2-agonist/muscarinic-antagonists), or non-users of ICS, with Cox regression adjusted for age, sex, and other confounders. We repeated these analyses among influenza test-positive patients during 2010-2018. Results Among 2,180 hospitalized SARS-CoV-2 patients, 282 were admitted to ICU and 421 died within 30 days. ICS use was associated with a hazard ratio of 1.25 (95% CI [CI], 0.60 to 2.61) for ICU admission and 0.84 (95% CI, 0.54 to 1.31) for death compared with non-ICS inhaler use. Compared with no ICS use, the hazard ratio of ICU admission or death was 1.22 (95% CI, 0.77 to 1.94) and 1.05 (95% CI, 0.75 to 1.47), respectively. Among 10,279 hospitalized influenza patients, the hazard ratios were 1.43 (95% CI, 0.89 to 2.30) and 1.11 (95% CI, 0.85 to 1.46) for ICU admission, and 0.80 (95% CI, 0.63 to 1.01) and 1.03 (95% CI, 0.87 to 1.22) for death compared with non-ICS inhaler use and no ICS use, respectively. Conclusions Our results do not support an effect of inhaled corticosteroid use on COVID-19 morbidity, however we can only rule out moderate-to-large reduced or increased risks.

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Section: Discussionsupporting

confidence: 91%

Inhaled corticosteroid use in COVID-19

Husby

Pottegaard

Hviid

2020

Preprint

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“…To this date, more than 4 billion vaccine doses have been administered worldwide [1], many of them mRNA-based vaccines. The occurrence of serious adverse events seen thus far is extremely rare, as opposed to the proven mortality and morbidity, both short and long term, of the COVID-19 disease [2][3][4][5][6]. Despite the clear evidence that vaccination is beneficial, vaccination hesitancy is a major obstacle to overcoming the pandemic, fueled by anti-vaccination movements and exaggerated media coverage and social media exposure [7,8].…”

Section: Introductionmentioning

confidence: 99%

Occurrence of BNT162b2 Vaccine Adverse Reactions Is Associated with Enhanced SARS-CoV-2 IgG Antibody Response

et al. 2021

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Promoting SARS-CoV-2 vaccination has been a global mission since the first vaccines were approved for emergency use. Alongside the excitement following the possibility of eradicating SARS-CoV-2 and ending the COVID-19 pandemic, there has been ample vaccine hesitancy, some due to the abundant reporting of adverse reactions. We report here that the occurrence of BNT162b2 vaccine adverse reactions is associated with enhanced antibody response. We found a statistically significant correlation between having an adverse reaction, whether local or systemic, and higher antibody levels. No sex difference was observed in antibody levels. However, as was recently reported, the antibody response was found to be lower among older vaccinees. The demonstration of a clear correlation between adverse reactions and antibody levels may help reduce vaccination hesitancy by reassuring that the presence of such reactions is an indication of a well-functioning immune system.

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“… 14 Furthermore, in parallel with other reports we found COVID‐19 to be associated with a markedly high level of overall morbidity and mortality compared with influenza. 23 , 24 This finding underscores the severity of COVID‐19, since our COVID‐19 cohort was both younger and generally healthier than our influenza cohort was.…”

Section: Discussionmentioning

confidence: 51%

Association between inhaled corticosteroid use and COVID‐19 outcomes

Husby

Pottegård

Hviid

2021

Pharmacoepidemiology and Drug

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Background Recent evidence has established a beneficial effect of systemic corticosteroids for treatment of moderate‐to‐severe COVID‐19. Objective To determine if inhaled corticosteroid use is associated with COVID‐19 outcomes. Methods In a nationwide cohort of hospitalized SARS‐CoV‐2 test‐positive individuals in Denmark, we estimated the 30‐day hazard ratio of intensive care unit (ICU) admission or death among users of inhaled corticosteroids (ICS) compared with users of bronchodilators (β 2 ‐agonist/muscarinic‐antagonists), and non‐users of ICS overall, with Cox regression adjusted for age, sex, and other confounders. We repeated these analyses among influenza test‐positive patients during 2010–2018. Results Among 6267 hospitalized SARS‐CoV‐2 patients, 614 (9.8%) were admitted to ICU and 677 (10.8%) died within 30 days. ICS use was associated with a hazard ratio of 1.09 (95% CI [CI], 0.67 to 1.79) for ICU admission and 0.78 (95% CI, 0.56 to 1.11) for death compared with bronchodilator use. Compared with no ICS use overall, the hazard ratio of ICU admission or death was 1.17 (95% CI, 0.87–1.59) and 1.02 (95% CI, 0.78–1.32), respectively. Among 10 279 hospitalized influenza patients, of which 951 (9.2%) were admitted to ICU and 1275 (12.4%) died, the hazard ratios were 1.43 (95% CI, 0.89–2.30) and 1.11 (95% CI, 0.85–1.46) for ICU admission, and 0.80 (95% CI, 0.63–1.01) and 1.03 (95% CI, 0.87–1.22) for death compared with bronchodilator use and no ICS use overall, respectively. Conclusion Our results do not support an effect of inhaled corticosteroid use on COVID‐19 outcomes, however we can only rule out moderate‐to‐large reduced or increased risks. Study registration The study was pre‐registered at encepp.eu (EUPAS35897).

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30-day mortality and morbidity in COVID-19 versus influenza: A population- based study

Cited by 8 publications

References 31 publications

Inhaled corticosteroid use in COVID-19

Inhaled corticosteroid use in COVID-19

Occurrence of BNT162b2 Vaccine Adverse Reactions Is Associated with Enhanced SARS-CoV-2 IgG Antibody Response

Association between inhaled corticosteroid use and COVID‐19 outcomes

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