First published 6 July 2020
  • QUT mathematician, physician and Australian Research Council Future Fellow, Associate Professor Dan Nicolau, is a lead researcher in the STOIC (STerOids In COVID-19) trial.
  • The trial is looking at whether asthma inhalers given to people with early stage COVID-19 can reduce progression of respiratory illness and cut emergency department presentations and hospital admissions.
  • Recruitment for the trial has begun through the Churchill Hospital in Headington in the UK.

Associate Professor Nicolau and the QUT team, including Honours student Alexander Hasson, will be coordinating trial data analysis, modelling of pathological mechanisms and building COVID-19 maths models to explain and use the clinical trial data to optimise patient treatment.

The STOIC trial clinical lead is University of Oxford Professor Mona Bafahdel and collaborators include former QUT Postdoctoral Research Fellow Dr Nabil Fadai, recently appointed to Assistant Professor in Mathematical Biology at the University of Nottingham. Associate Professor Nicolau and Professor Bafahdel have discussed the trial rationale in an article in the medical journal The Lancet.

QUT Associate Professor Dan Nicolau


Associate Professor Nicolau, from the QUT Science and Engineering Faculty School of Mathematical Sciences, said about 500 patients are needed for the trial.

Some patients will be given the corticosteroid budesonide, while others are given a placebo. Budesonide is an inexpensive, widely prescribed inhaler medication used by people with asthma to prevent and control symptoms. It acts to reduce irritation and inflammation of the lungs and airways.

Associate Professor Nicolau said he and Professor Bafahdel, a respiratory physician and mentor since his medical studies at Oxford, had noticed early on in the pandemic that people with asthma and the chronic lung disease COPD were under-represented in the numbers of seriously ill COVID-19 patients.

“This seemed paradoxical because COVID-19 affects the lungs – and these patients have lung problems – so they should be more at risk of severe disease from the virus,” he said.

“One explanation for the low numbers was that something these people were doing regularly was protecting them and that, logically, was that they routinely used inhalers for their chronic lung problems.

“Ideally it may be that the corticosteroid therapy would be given to anyone with a new, dry cough, and while they are awaiting their COVID test results.”

Associate Professor Nicolau said mathematical modelling by the STOIC study team suggests that “the earlier we apply the inhaled steroid treatment the more people we’ll be able to keep from getting sick”.

University of Oxford researchers recently released promising preliminary results from a separate RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial of another corticosteroid, dexamethasone, in treating COVID-19 patients.  Dexamethasone, which is taken by mouth rather than inhaled, is used to treat a range of inflammatory-related conditions including allergies, arthritis and severe asthma. Early data from the RECOVERY trial reported that the drug reduced deaths by one-third among COVID-19 patients who were on ventilators in intensive care units.


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