Evidence map›Paper›PMID 41485772›Full record

ArticlePharmacoepidemiology and drug safety2026

Risk of Hospitalized COVID-19 in COPD: Single-Inhaler Triple Versus Dual Bronchodilator Therapy.

Simon Galmiche, Sophie Dell'Aniello, Samy Suissa

Abstract readComparative Study
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Simon GalmicheCenter for Clinical Epidemiology, Lady Davis Institute (LDI), Jewish General Hospital, Montreal, Canada.
Sophie Dell'AnielloCenter for Clinical Epidemiology, Lady Davis Institute (LDI), Jewish General Hospital, Montreal, Canada.
Samy SuissaCenter for Clinical Epidemiology, Lady Davis Institute (LDI), Jewish General Hospital, Montreal, Canada.ORCID https://orcid.org/0000-0002-1281-5296

Funding

Canadian Foundation for Innovation (CFI)Canadian Institutes of Health Research (CIHR)
6 · The paper itself

Abstract

purposeOur objective was to estimate the effect of initiating an inhaled corticosteroids-containing single-inhaler triple agent (ICS-LABA-LAMA) compared with a single-inhaler LABA-LAMA dual bronchodilator in patients with COPD on the risk of severe COVID-19 prior to the roll-out of vaccines.

methodsWe conducted a cohort study emulating a randomized trial, among patients with COPD aged 40 years or more in the UK, comparing those who initiated a triple inhaler with those who initiated a dual bronchodilator inhaler between March 1 and December 31, 2020. Weighting by fine stratification of the propensity score was used to account for confounders. The risk of hospitalized COVID-19 was compared with a Cox proportional hazards model in an as-treated analysis with a 30-day grace period.

resultsThe study cohort included 876 patients initiating a triple inhaler and 5010 initiating a dual LABA-LAMA inhaler. The adjusted incidence rate of hospitalized COVID-19 was 5.6 per 100 person-years in the triple inhaler group and 2.9 per 100 person-years in the dual inhaler group, with a corresponding hazard ratio (HR) of 1.96 (95% confidence interval 1.01-3.77). Sensitivity analyses on the duration of the grace period, using an intent-to-treat exposure classification, or starting follow-up 14 days after treatment initiation (accounting for treatment initiation for an undocumented SARS-CoV-2 infection) were generally consistent with the main analysis.

conclusionsPatients with COPD prescribed an ICS-containing triple inhaler were potentially exposed to an increased risk of severe COVID-19 prior to the vaccine era. As SARS-CoV-2 continues to cause significant burden, these findings should be considered when determining initiation of inhaled treatment in COPD.

Indexed as

Adrenal Cortex HormonesBronchodilator AgentsCOVID-19HospitalizationPulmonary Disease, Chronic ObstructiveAdministration, InhalationAdultAgedCohort StudiesDrug CombinationsDrug Therapy, CombinationFemaleHumansMaleMiddle AgedNebulizers and VaporizersAdrenal Cortex HormonesBronchodilator AgentsDrug Combinationsdrug safetyinfectioninhaled corticosteroidsnew‐user cohort

Identifiers

PMID41485772
PMCPMC12765584

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.