Efficacy of steroids on COVID-19

RI-MUHC clinical trial COVID-19: clinical trial of ciclesonide to possibly prevent mild cases of COVID-19 from worsening

Based on her prior positive experiences using ciclesonide to decrease viral replication of SARS-CoV-2 in mouse models, Dr. Nicole Ezer, lung specialist and researcher in the RESP Program at the RI-MUHC, designed a trial to test the efficacy of the inhaled steroid on respiratory symptoms of adults with COVID-19. Study participants were recruited between September 5, 2020 and June 8, 2021 and the study was completely contactless. For the CONTAIN phase II randomized control trial, all documentation was completed online, from enrollment to reporting results. Medication for the trial was delivered to the participants at home. The researchers never met with the participants in person.

Results of this study showed no significant difference between the participants who used the steroid and those who did not, but researchers still believe in the potential usefulness of inhaled steroids to treat symptoms of COVID-19.

“It’s still possible that inhaled steroids might be beneficial for older at risk populations.” “We need more research focused on older adults and people who are high-risk,…”

Dr. Nicole Ezer

Given this continued belief in the efficacy of steroids, we will likely see other studies designed to use an inhaled steroid to help at-risk populations. The success of the contactless aspect to the study means that future studies can include participants who remain at home or live in other provinces, and will also be useful for future pandemics.

Having a placebo arm to this study is also important and gives strength to the results. Previous studies were limited by their lack of placebo, despite inhalers being known to have a strong placebo effect.

Read more about the study and findings here:

Can inhaled corticosteroids alleviate early symptoms of COVID-19? RI-MUHC Research News, November 2, 2021.

Inhaled and intranasal ciclesonide for the treatment of covid-19 in adult outpatients: CONTAIN phase II randomised controlled trial BMJ, 2021 Nov 2;375:e068060. doi: 10.1136/bmj-2021-068060. PMID: 34728476.