Corticosteroids, COVID-19 pneumonia, and acute respiratory distress syndrome

Matthay, Michael A.; Wick, Katherine D.

doi:10.1172/jci143331

Cited by 58 publications

(43 citation statements)

References 22 publications

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“…This discrepancy illustrates the potential value of focusing on distinct ARDS phenotypes based on clinical risk factor-that is, the signal for corticosteroid benefit is much clearer in COVID-19 ARDS than it has been in 50 years of study in non-COVID-19 ARDS. However, even the role of corticosteroids in COVID-19 will require more study to understand when dexamethasone may be harmful or beneficial [35] and will need re-evaluation in conjunction with new therapies that may show efficacy as well, including potentially monoclonal antibodies, immunomodulatory agents, and new anti-viral therapies.…”

Section: Figmentioning

confidence: 99%

Phenotypes and personalized medicine in the acute respiratory distress syndrome

et al. 2020

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Section: Figmentioning

confidence: 99%

Phenotypes and personalized medicine in the acute respiratory distress syndrome

et al. 2020

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“…By a group of 70 matched patients, Yuan et al [ 38 ] concluded that corticosteroid might harm lung injury recovery in non-severe COVID-19 pneumonia patients. As an effective candidate treatment therapy, the corticosteroid is being concerned by researchers recently [ 39–41 ]. However, more attention should be paid to severe and critical patients.…”

Section: Discussionmentioning

confidence: 99%

Corticosteroids treatment in severe patients with COVID-19: a propensity score matching study

Chen

Song

Wang

et al. 2021

Expert Review of Respiratory Medicine

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Objectives: To explore the efficacy of corticosteroid treatment in patients with severe COVID-19 pneumonia and the association between corticosteroid use and patient mortality. Methods: A retrospective investigation was made on the medical records of the patients with severe and critical patients with COVID-19 pneumonia from January to February 2020. First, the patients who received corticosteroid treatment were compared with patients without given corticosteroid treatment. Then a propensity score matching method was used to control confounding factors. Cox survival regression analysis was used to evaluate the effect of corticosteroid therapy on the mortality of severe and critical patients with COVID-19. Results: A total of 371 severe and critical patients were included in our analyses. 209 patients were treated with corticosteroid therapy. Most of them were treated with methylprednisolone (197[94.3%]). The median corticosteroid therapy was applied 3(IQR 2-6) days after admission, 13(IQR 10-17) days after symptoms appeared. Temperature on admission(OR=1.255,[95%CI 1.021-1.547],p=0.032), ventilation(OR=1.926,[95%CI 1.148-3.269],p=0.014) and ICU admission(OR=3.713, [95%CI 1.776-8.277],p<0.001) were significantly associated with corticosteroids use. After PS matching, the cox regression survival analysis showed that corticosteroid use was significantly associated with a lower mortality rate (HR=0.592, [95%CI 0.406-0.862], p=0.006). Conclusion: Corticosteroid therapy use in severe and critical patients with COVID-19 pneumonia leads to lower mortality but may cause other side effects. Corticosteroid therapy should be used carefully.

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“…в течение первых 7-10 дней болезни) может повлечь за собой усугубление последней с дальнейшим нарастанием интенсивности воспалительного ответа и выраженным ухудшением состояния больного. Как отмечают M. Matthay и K. Wick [21], ГК могут оказывать как пагубное, так и благоприятное воздействие на разных стадиях SARS-CoV-2-инфекции, поражения легких и ОРДС [22]. Таким образом, оптимальное время назначения, доза и продолжительность приема ГК с точки зрения эффективности и безопасности остаются предметом дальнейших исследований.…”

Section: Covid-19 -это проблема тромбовоспаления и аутоиммунитетаunclassified

COVID-19 and rheumatology: A year later

Белов¹,

Лила²

2021

Naučno-praktičeskaâ revmatologiâ

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An enormous body of evidence on various aspects of the coronavirus disease 2019, COVID-19 associated with the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus-2) has been accumulated over the past year. Meanwhile, investigated relationship between COVID-19 and rheumatic immune-mediated inflammatory diseases (IMIDs) and certain identified similarities were of paramount importance. It was shown that the incidence of COVID-19 in patients with rheumatic diseases does not significantly differ from that in general population. The risk of severe course and unfavorable COVID-19 outcomes in patients with rheumatic IMIDs is significantly associated with older age and comorbidities – as in general population, and is not aggravated by preceding use of the majority of antirheumatic drugs. Gaining better insights into pathogenesis of COVID-19 provided sound prerequisites for anti-rheumatic drugs repurposing and substantiated their use for treatment of COVID-19 infection. Under current COVID-19 pandemic circumstances, accelerated development and invention of various COVID-19 vaccines offers a great hope to curb the tide of pandemic. However, the efficacy, immunogenicity, and safety of these vaccines in patients with rheumatic IMIDs must be studied in controlled clinical trials. Generally speaking, there are still numerous blind spots in our knowledge of rheumatological aspects of such a versatile and polymorphous condition as COVID-19 infection.

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Corticosteroids, COVID-19 pneumonia, and acute respiratory distress syndrome

Cited by 58 publications

References 22 publications

Phenotypes and personalized medicine in the acute respiratory distress syndrome

Phenotypes and personalized medicine in the acute respiratory distress syndrome

Corticosteroids treatment in severe patients with COVID-19: a propensity score matching study

COVID-19 and rheumatology: A year later

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