Covid-19: Asthma spray protects against a severe course
Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.
More posts by Christiane Fux All content is checked by medical journalists.Even severe courses of Covid-19 start mildly. A common asthma spray that contains cortisone can potentially prevent many patients' condition from worsening dramatically. Is this the longed-for breakthrough in Covid-19 therapy?
The team led by Mona Bafadhel from the University of Oxford had won 146 Covid-19 patients for its study. These were still in the first phase of the disease. On average, they noticed the first symptoms three days, a maximum of seven days before the start of the study.
At this point in time, the symptoms were still mild in all participants. The patients only suffered from typical symptoms such as cough, fever, headache and fatigue. Some also observed a loss of their sense of smell and taste.
90 percent fewer hospital admissions
The researchers randomly prescribed half of the participants twice a day over an average period of seven days from an asthma inhaler containing the cortisone active ingredient budesonide. Only one of this group had to be treated further in the hospital. In contrast, there were ten in the control group that had not received cortisone. That means: The cortisone spray was able to reduce the risk of severe Covid-19 courses by 90 percent.
The more easily ill participants in the cortisone group also benefited: They suffered less or less long from fever and other complaints. On average, they overcame the disease with cortisone support one day earlier than the participants in the control group.
Asthmatics are less likely to get seriously ill
The first studies from China already provided an indication of the possible effectiveness of cortisone in Covid-19. It was already noticed at that time that asthmatics after an infection with SARS-CoV-2 are comparatively seldom seriously ill with COVID-19 - even though, given their previously damaged lungs, more severe courses would have been expected.
Even then, experts suspected that the solution to the riddle could lie in the cortisone sprays used. Experiments confirmed that glucocorticoids inhibit the replication of SARS-CoV-2 in the airways.
In the case of severe courses of Covid-19, the steroid dexamethasone is now used as standard and with success. The so-called recovery study had shown in advance that seriously ill patients who received the cortisone preparation survived the infection more often.
Effective, inexpensive, with few side effects?
If the effect of the asthma spray containing cortisone is confirmed, that would be very good news. Many hospital admissions due to Covid-19 could be prevented in this way. At the same time, the remedy is cheap and tolerable enough to be used widely. According to the SPD health expert and physician Karl Lauterbach, this could even be a "game changer" in the treatment of Covid-19.
Small study, little evidential value
However, the informative value of the study is very limited. Mainly because the total number of participants is too small for solid data. However, there is also no comparison with a placebo group that receives an active ingredient-free spray instead of cortisone. Ideally, who receives which preparation should also be double-blinded - this means that neither the treating physicians nor the participants should first find out who is receiving the active ingredient and who is not.
Results not yet reviewed by colleagues
The study has so far only appeared in preprint. This means that the results have not yet been verified by independent colleagues.
So far, asthma sprays cannot be recommended as a standard therapy for use in mild Covid-19 courses. But since the data seem so promising, the researchers hope to be able to check the effect in a larger study in the near future.
First hyped, then disenchanted
But this could lead to disillusionment: In the course of the pandemic there were already a number of drugs in which great hopes were placed - and which on closer examination then proved to be ineffective or even harmful.
This is what happened with the malaria drug chloroquine (ineffective and dangerous), as propagated by Donald Trump, and with the Ebola drug remdesivir, which shortens the treatment time for seriously ill patients somewhat, but does not significantly reduce the death rate.
And there is another blemish: The budesonide inhaler used comes from the pharmaceutical company AstraZeneca - and that also sponsored the study.
