The Covid-19 pandemic has led to a surge in the search for potential therapies. However, many of them have focused on the moderate or severe forms of the disease. People with early mild Covid-19 often get symptom-relieving medications like antipyretics, vitamin C with or without vitamin D as clinicians see fit. They then monitor them, and those that cross over to moderate or severe Covid-19 get inpatient care as per treatment protocol. Inhaled budesonide may change this pattern as it may be effective in early mild Covid-19 with subtle adverse effects as per the STOIC (Steroids in Covid-19) trial.
Inhaled budesonide is the mainstay therapy among patients with asthma or chronic pulmonary obstructive disease (COPD), and it has provided excellent efficacy since its inception. Early reports about the nature of Covid-19 patients showed that people with asthma or COPD and had Covid-19 were fewer than had initially predicted. Researchers at the STOIC trial thought that inhaled glucocorticoids were responsible for this observation. They then enrolled patients with early mild Covid-19 to either receive inhaled budesonide at approximately 400µg twice a day for an average of seven days. The objective was to ascertain which of the two groups had more patients who required urgent medical evaluation or hospitalisation at twenty-eight days. The results were sublime. Only 1.4% of the Budesonide group required dire medical evaluation or hospitalisation visa viz 14.4% in the standard care group. Budesonide showed that it might alleviate Covid-19-related symptoms. It also reduced the probability of any hospitalisation due to worsening disease. We should, however, note that the study had a small number of participants (139).
Inhaled budesonide is a locally acting corticosteroid. It alleviates symptoms related to asthma or chronic obstructive pulmonary disease – reducing exacerbations among this population. Most exacerbations are due to viral infections. Studies have shown that inhaled glucocorticoids reduce coronavirus replication in lung tissues. They also downregulate the expression of the genes that the virus uses to enter the cells. It may be the reason behind the observed benefits among patients with mild Covid-19.
Budesonide provides a cheap, yet readily available therapeutic option for home-based management of Covid-19. It is noteworthy that only the STOIC trial has shown the potential benefit of inhaled corticosteroids among patients with early mild Covid-19. More studies are necessary to substantiate this benefit. Do not self-medicate. Visit a licensed health care provider and discuss how they can manage your Covid-19 using the available therapeutic agents as they see fit.
For more information about the STOIC trial, click here.