Implementation of corticosteroids in treatment of COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK: prospective, cohort study

Närhi, Fiina; Moonesinghe, Suneetha Ramani; Shenkin, Susan D.; Drake, Thomas M; Mulholland, Rachel; Donegan, Cara; Dunning, Jake; Fairfield, Cameron J; Girvan, Michelle; Hardwick, Hayley; Ho, Antonia; Leeming, Gary; Nguyen‐Van‐Tam, Jonathan S; Pius, Riinu; Russell, Clark D; Shaw, Catherine; Spencer, Rebecca G.; Turtle, Lance; Openshaw, Peter; Baillie, J Kenneth; Harrison, Ewen M; Semple, Malcolm G; Docherty, Annemarie B

doi:10.1016/s2589-7500(22)00018-8

Cited by 28 publications

(20 citation statements)

References 16 publications

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“…net/files/recovery-in-pregnant-women-for-hcp-v15-1-2021-12-22.pdf) (https://clinicaltrials.gov/ct2/show/NCT04765384) and others 6 . Consequently, effective treatments such as corticosteroids for severe COVID-19 patients which was implemented into clinical practice in the UK in June 2020, remain less frequently used in pregnant than nonpregnant women 7 .…”

Section: Pregnant Women In Covid-19 Clinical Trialsmentioning

confidence: 99%

Call for a unified approach to Monkeypox infection in pregnancy: Lessons from the COVID-19 pandemic

et al. 2022

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Section: Pregnant Women In Covid-19 Clinical Trialsmentioning

confidence: 99%

Call for a unified approach to Monkeypox infection in pregnancy: Lessons from the COVID-19 pandemic

et al. 2022

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“…COVID-19 has caused an enormous number of deaths due to the poor information on SARS-CoV-2 and its exact mechanisms of action. Substantial progresses have been recently made in science and technology, improving the management of COVID-19 patients (Kaur and Gupta, 2020;Stasi et al, 2020;Tregoning et al, 2020;Ulinici et al, 2021;Gupta et al, 2022;Narhi et al, 2022;Vincent et al, 2022;Weerakkody et al, 2022). However, the war is not over yet, inasmuch as the COVID-19 pandemic leaves substantial aftermaths due to the long-term complications of the disease which are often disabling, reducing the quality of life (Crook et al, 2021;Iqbal et al, 2021;Michelen et al, 2021;Desai et al, 2022;Robineau et al, 2022;Whitaker et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Exosomal miR-145 and miR-885 Regulate Thrombosis in COVID-19

Gambardella

Kansakar

Sardu³

et al. 2022

J Pharmacol Exp Ther

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We hypothesized that exosomal microRNAs (miRNAs) could be implied in the pathogenesis of thromboembolic complications in COVID-19. We isolated circulating exosomes from COVID-19 patients and then we divided our population in two arms based on the D-dimer level on hospital admission. We observed that exosomal miR-145 and miR-885 significantly correlate with D-Dimer levels. Moreover, we demonstrate that human endothelial cells express the main cofactors needed for SARS-CoV-2 internalization, including ACE2, TMPRSS2, and CD-147. Interestingly, human endothelial cells treated with serum from COVID-19 patients release significantly less miR-145 and miR-885, exhibit increased apoptosis, and display significantly impaired angiogenetic properties compared to cells treated with non-COVID-19 serum. Taken together, our data indicate that exosomal miR-145 and miR-885 are essential in modulating thromboembolic events in COVID-19.

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“…As an illustration, treatment with corticosteroids variably increased the chance of survival or harmed hospitalized COVID-19 patients during the first wave in 2020 [ 3 ]. During the subsequent pandemic waves, the use of corticosteroids was informed by evidence-based guidelines [ 4 ], with high compliance of physicians to these guidelines [ 5 ]. In this issue of the journal, Torres et al highlighted the substantial heterogeneity in response to corticosteroids in a large cohort of critical COVID-19 patients [ 6 ].…”

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confidence: 99%

“…The authors also found that early initiation of corticosteroids was associated with an increased risk of dying and a longer duration of treatment (10 days or more) with increased chance of survival. Taking together information from a systematic review of randomized trials [ 4 ] and large and low risk of bias observational cohorts [ 5 , 6 ], the need for mechanical ventilation is a strong predictor of survival benefits from corticotherapy, and too early (< 7 days from infection) treatment initiation is a strong predictor of harm. Based on RECOVERY data [ 7 ], one additional life was saved for every 36 patients treated with corticosteroids.…”

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confidence: 99%