Asthma drug may reduce risk of severe Covid if taken early – study

A cheap and widely available asthma drug appears to significantly reduce the risk of people getting seriously ill with Covid-19, if it is taken within the first week of developing symptoms, research suggests.

If the results are confirmed by other ongoing studies, inhaled budesonide – which both stops people from getting worse and shortens the length of their illness – could become the first treatment in the early stages of infection.

The Stoic study was launched following observations that people with asthma or chronic obstructive pulmonary disease (COPD) were surprisingly underrepresented among hospital patients admitted with Covid-19, when other respiratory illnesses such as flu, tend to make their symptoms worse. One possibility was that the steroid inhalers they use to manage their asthma and COPD symptoms were protecting some of them from severe Covid-19.

Related: CDC study recommends double masking to reduce Covid-19 exposure

One such drug is budesonide, which is often given in a white “turbuhaler” or a brown or beige “preventer” inhaler because it helps to prevent people with asthma or COPD from getting symptoms.

Prof Mona Bafadhel at the University of Oxford and her colleagues recruited 146 otherwise healthy adults with early Covid-19 symptoms, and instructed half of them to take 800 micrograms of budesonide twice a day until they felt better, while the other volunteers received usual care (ie no treatment).

Watch: Covid-19 vaccines used across the UK are safe, new MHRA analysis shows

Ten of these people eventually required hospital assessment or treatment, compared with just one of those allocated a budesonide inhaler. They also experienced a faster resolution of fever and other Covid-19 symptoms – and had fewer persistent symptoms after 28 days, suggesting the drug may also reduce people’s chances of developing “long Covid”.

One possibility is that the drug reduces inflammatory damage to cells in the airways and lungs caused by our immune response to the virus. Other studies have suggested it may reduce viral replication in these cells, or make it harder for the virus to latch on to them in the first place.

Bafadhel said: “Although this is a small study, it is encouraging to know that there are at least five other studies being done across the world that are also looking at different classes of inhaled corticosteroids.”

One of these, the Principle trial, which is also being led by Oxford researchers, is evaluating budesonide as a treatment for older adults with early Covid-19 symptoms, including those with underlying health conditions.

Bafadhel added: “The vaccines are obviously very exciting, but at the moment there isn’t any drug that treats you when you are poorly, to stop you getting worse. I am heartened that a relatively safe, widely available and well-studied medicine such as an inhaled steroid could have an impact on the pressures we are experiencing during the pandemic.”

The study, which has not yet been reviewed by other scientists, suggested that eight people would require treatment with budesonide to prevent one from needing hospital treatment.

Dr James Dodd, a consultant senior lecturer in respiratory medicine at North Bristol Lung Centre and the University of Bristol, said: “If that level of efficacy is reproduced in a larger study, including older age groups with other comorbidities, you really have got potentially a very exciting, cheap, safe, widely available treatment for patients in the community who have just been diagnosed with Covid-19.

“Within a short period of time we could potentially have the first community-based treatment – one which would also presumably be less vulnerable to the virus acquiring new mutations than the vaccines.”

Watch: Should I pay off debt or save money during the coronavirus pandemic?