The effect of inhaled corticosteroids on the outcomes of patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Expert Rev Clin Pharmacol. 2022 May;15(5):593-600. doi: 10.1080/17512433.2022.2094769. Epub 2022 Jul 10.


Background: The effect of inhaled corticosteroids (ICS) on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) was not known.

Research design and methods: Only phase 2 and 3 randomized clinical trials (RCTs) from electronic databases that investigated ICS in the treatment of COVID-19 patients were included. The outcomes of interest were the resolution of symptoms, risk of hospitalization or urgent medical visit, mortality, and the incidence of adverse events (AEs).

Results: Five RCTs involving 1243 patients who received ICS and 1526 patients with placebo or usual care were included. The ICS group had a higher rate of symptom resolution than the control group at day 14 (risk ratio [RR], 1.21; 95% confidence interval [CI], 1.12-1.30, p < 0.00001) and day 28 (RR, 1.12; 95% CI, 1.06-1.18, p < 0.0001). Additionally, the ICS group had a significantly lower risk of needing urgent medical care or hospitalization than the control group (RR, 0.15; 95% CI, 0.05-0.50; I2 = 0, p = 0.002). However, no significant difference in the 28-day mortality rate.

Conclusions: In patients with mild-to-moderate COVID-19, ICS therapy improved symptom resolution, and decreased the risk of needing urgent medical care or hospitalization.

Keywords: COVID-19; SARS-CoV-2; inhaled corticosteroids.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents* / therapeutic use
  • Asthma* / drug therapy
  • COVID-19 Drug Treatment*
  • Humans
  • Randomized Controlled Trials as Topic


  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents