1. 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, A., 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., CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Virulence Bactérienne et Infections Chroniques (VBIC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre d'Investigation Clinique de Limoges (CIC1435), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), and This work was not funded. The study sites received funding from Sanofi Pasteur and MSD for the FLUVAC study. Vaccine producers had no role in the study design, data analysis, decision to publish or preparation of the manuscript.
- Subjects
Adult ,Multidisciplinary ,[SDV]Life Sciences [q-bio] ,Respiratory Syncytial Virus Infections ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Adrenal Cortex Hormones ,Virus Diseases ,Respiratory Syncytial Virus, Human ,Influenza, Human ,Viruses ,Humans ,Prospective Studies ,Respiratory Tract Infections - Abstract
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.
- Published
- 2021
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