Steroid Nasal Sprays Can Lessen the Development of Severe COVID-19 Infections

Individuals who regularly use steroid nasal sprays are less likely to develop a severe COVID-19 infection, the results of a Cleveland Clinic study show.

“Our findings are particularly significant, as decreased COVID-19 hospitalizations, [intensive care unit (ICU)] admissions, and mortality could alleviate the strain on health care systems with limited resources across the globe, especially in developing countries where there is limited access to vaccines and where mutations in SARS-CoV-2 have emerged,” Ronald Strauss, MD, an allergist-immunologist and director of the Cleveland Allergy and Asthma Center, said in a statement.

In the study, investigators included 72,147 COVID-19-positive individuals, aged 18 years and older, within the Cleveland Clinic health system from the beginning of April 2020 to the end of March 2021.

Individuals who used an intranasal corticosteroid, which are nasal sprays in the steroid family, prior to COVID-19 were 22% less likely to be hospitalized, 23% less likely to be admitted to the ICU, and 24% less likely to die from COVID-19 during hospitalization than individuals who did not use a steroid nasal spray.

Of these individuals, 17.5% were hospitalized, 4.1% were admitted to the ICU, and 2.6% died during hospitalization. Additionally, 14.1% of individuals received a steroid nasal spray prior to the COVID-19 infection.

“This study shows the importance of the nose in COVID-19 infection,” Joe Zein, MD, PhD, a pulmonologist at Cleveland Clinic, said in the statement.

“The nose, in this instance is the gateway to our bodies, allowing the virus to enter and replicate within,” he said. “The use of intranasal corticosteroids may help disrupt that gateway.”

The study results suggest that intranasal corticosteroids decrease the protein receptor ACE2, which allows the SARS-CoV-2 virus that causes COVID-19 to enter cells and spread the disease. ACE2 expression is highest in the nasal mucosa, so suppressing the receptors could potentially be affective against COVID-19.

More studies are needed to further these findings, according to investigators.

The study was published in the Journal of Allergy and Clinical Immunology: In Practice.

Reference

Cleveland clinic study suggests steroid nasal sprays may help improve outcomes in severe COVID-19 disease. EurekAlert. News release. September 28, 2021. Accessed September 29, 2021. https://www.eurekalert.org/news-releases/929812