Early treatment of COVID-19 is feasible using several different existing drugs, including budesonide. A review of the current research is provided.

Key Messages

According to this comprehensive literature review, randomized clinical trials show that inhaled budesonide is one of the promising, existing drugs available to treat patients with mild cases of COVID-19. Patients given inhaled budesonide showed much lower rates of emergency room visits and/or hospitalization.

In one study of the COVID-19-causing virus, budesonide was shown to reduce the ability of SARS-CoV-2 to replicate in airway epithelial cells grown in the laboratory. COVID-19 patients may benefit from taking inhaled budesonide, a drug routinely prescribed for asthma and COPD, early during their illness. .

Early drug treatments for COVID-19 are largely supported by evidence-based medicine, and may be beneficial for developing nations where non-pharmaceutical interventions have proven to be difficult because of social inequities and illiteracy.

Existing drugs such as budesonide, which are both cost-effective and evidence-based, can be used by developing countries that have limited resources.

International Journal of Environmental Research and Public Health

Publication Date: July 5, 2021
Peer Reviewed: Yes
Publication Type: Review/Commentary/Letter
DOI: https://www.doi.org/10.3390/ijerph18137212

Pharmacological Treatment of Patients with Mild to Moderate COVID-19: A Comprehensive Review

Reinaldo B. Bestetti, Rosemary Furlan-Daniel, Vinicius M. R. Silva


Mild to moderate COVID-19 can be found in about 80% of patients. Although mortality is low, mild to moderate COVID-19 may progress to severe or even critical stages in about one week. This poses a substantial burden on the health care system, and ultimately culminates in death or incapacitation and hospitalization. Therefore, pharmacological treatment is paramount for patients with this condition, especially those with recognized risk factors to disease progression. We conducted a comprehensive review in the medical literature searching for randomized studies carried out in patients with mild to moderate COVID-19. A total of 14 randomized studies were identified, enrolling a total of 6848 patients. Nine studies (64%) were randomized, placebo-controlled trials, whereas five were open-label randomized trials (35%). We observed that Bamlanivimab and nitazoxanide reduced viral load, whereas ivermectin may have shortened time to viral clearance; Interferon Beta-1 reduced time to viral clearance and vitamin D reduced viral load; Favirapir, peginterferon, and levamisole improved clinical symptoms, whereas fluvoxamine halted disease progression; inhaled budesonide reduced the number of hospitalizations and visits to emergency departments; colchicine reduced the number of deaths and hospitalizations. Collectively, therefore, these findings show that treatment of early COVID-19 may be associated with reduced viral load, thus potentially decreasing disease spread in the community. Moreover, treatment of patients with mild to moderate COVID-19 may also be associated with improved clinical symptoms, hospitalization, and disease progression. We suggest that colchicine, inhaled budesonide, and nitazoxanide, along with nonpharmacological measures, based on efficacy and costs, may be used to mitigate the effects of the COVID-19 pandemic in middle-income countries.