Budesonide: inhalation treatment suitable for high-risk populations?

Effective and safe treatment against COVID-19 needs to be developed quickly, especially for elderly or high-risk individuals. Amongst medicines currently used, corticosteroids seem to reduce mortality rates in hospitalised patients, but in certain cases can have harmful side-effects and are not unanimously favoured by the medical community. They can be administered locally by inhalation, or systemically by oral methods. Researchers at the University of Oxford (UK) and at KwaZulu–Natal (South Africa) have recently shown that inhalation of budesonide, a corticosteroid used in the treatment of asthma, could limit COVID in at-risk individuals.

The researchers carried out a multicentre study, involving patients from different sites in the UK,  who were randomly divided into groups. The study involved several treatments:  one group was treated with budesonide (1 073 individuals), another with the usual therapies (1 988 individuals) and a 3^rd with other treatments (1 639 individuals), making a total of 4 700 individuals. Selected participants were either older than 65, or older than 50 and with comorbidities. 2 655 individuals had tested positive for SARS-CoV-2, including 787 from the group treated with budesonide.

Budesonide may have helped to decrease inflammation in the lungs and to reduce the expression of the ACE2 receptor, the point of entry for the virus into the organism. Regarding recovery times, there was an average of 11 days in the group treated with budesonide, against 15 in the group having received conventional treatment. In the group having received budesonide, 9% of individuals were hospitalised and 6 people died, against 11% in the group receiving conventional treatments, amongst whom 11 people died.

The inhalation of Budesonide by at-risk individuals therefore gave potentially interesting results. Recovery time seemed to be reduced by about 3 days on average, and rates of hospitalisation and mortality, in cases of infection by COVID-19, may have been reduced in comparison with those treated conventionally. This treatment is not only available immediately, but is safe and inexpensive.