Effects of long-term corticosteroid use on susceptibility to respiratory viruses: a narrative review.

Background: Synthetic glucocorticoids are among the most commonly administered drugs due to their potent immunomodulatory properties. However, they may put patients at risk for infections. Their effect on the incidence of respiratory viral infections (RVIs) remains unclear.

Objectives: The aim of this review is to provide an insightful overview of the most up-to-date evidence regarding the extent to which the use of corticosteroids (CSs) influences the risk of RVIs.

Sources: The PubMed database was searched for studies on the association between CSs and RVIs from inception until 15 December 2023.

Content: CSs have differing impacts on the risk of RVIs in asthma and chronic obstructive pulmonary disease, influenced by both the specific virus and the type and dose of CSs. Furthermore, current data demonstrate that CSs may increase the risk of RVIs in patients with systemic lupus erythematosus, rheumatoid arthritis, vasculitis, solid tumours, haematological malignancies, and among transplant recipients.

Implications: Large-scale studies are imperative to inform a more accurate and personalized risk stratification for RVIs. This, in turn, will point towards new strategies for RVI prevention and associated morbidity and mortality in high-risk populations.