Steroids in COVID-19: An overview

Chatterjee, Kshitij; Wu, Chuanshen; Bhardwaj, Abhishek; Siuba, Matthew

doi:10.3949/ccjm.87a.ccc059

Cited by 38 publications

(53 citation statements)

References 23 publications

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“…As the COVID-19 pandemic continues to wreak havoc, there has been mounting fervor surrounding the use of several pharmacological agents in the treatment of severe COVID-19 infections. Numerous pharmacological regimens have been investigated to date, including hydroxychloroquine, azithromycin, remdesivir, and tocilizumab [ 8 ]. More recently, corticosteroids have been one of the major focuses as part of potential life-saving therapy, and this guidance is predominantly derived from their use during the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and middle east respiratory syndrome coronavirus (MERS-CoV) outbreaks [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have posited that the early administration of low-dose, short-course corticosteroids in mild and moderate COVID-19 cases has the potential to halt the progression of the disease process and improve clinical outcomes with no added adverse effects [6,7]. are mediated by the 1 1 2, 3 1 1 4 1 1 1 1 binding of glucocorticoids (GC) to GC receptors, thereby inhibiting the transcription of cytokines such as interleukin 6 (IL-6) that remain a hallmark of an aberrant immune response characteristic of a COVID-19 infection [8]. According to the current medical literature, steroids are effective in decreasing the overall mortality, the length of required oxygen therapy, and the mean length of hospital stay in patients infected with a severe COVID-19 infection [8].…”

Section: Introductionmentioning

confidence: 99%

“…Corticosteroids boast immunosuppressive and anti-inflammatory properties that are mediated by the binding of glucocorticoids (GC) to GC receptors, thereby inhibiting the transcription of cytokines such as interleukin 6 (IL-6) that remain a hallmark of an aberrant immune response characteristic of a COVID-19 infection [ 8 ]. According to the current medical literature, steroids are effective in decreasing the overall mortality, the length of required oxygen therapy, and the mean length of hospital stay in patients infected with a severe COVID-19 infection [ 8 ]. Recent medical literature has further suggested that the short-term administration of low-dose methylprednisolone in the early stages of the disease can ameliorate the prognosis by thwarting the progression of a mild or moderate COVID-19 infection.…”

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Low-Dose Corticosteroids in Patients With Non-severe Coronavirus Disease 2019: A Retrospective Cohort Study

Almas¹,

Ehtesham²,

Khan³

et al. 2021

Cureus

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Background To date, several pharmacological agents have been employed in the treatment and management of the coronavirus disease 2019 (COVID-19). While the utility of corticosteroids in severe COVID-19 infection is now widely touted, their efficacy in thwarting the progression of non-severe disease remains elusive. Methods A retrospective cohort study involving 25 patients with a confirmed diagnosis of non-severe COVID-19 infection was conducted. Subjects were assigned to either the steroid or the non-steroid group. A low-dose, short-course corticosteroid regimen was administered for seven days and the disease outcomes were recorded and compared among the two groups. The Kolmogorov-Smirnov test was employed to discern the data normality. Results In patients treated with low-dose, short-course steroids, the overall all-cause mortality was significantly lower compared with the non-steroid group (8.3% and 61.5%, respectively; p = 0.005). The prevalence of acute respiratory distress syndrome in the steroid group was significantly lower than that in the non-steroid group at the seven-day mark (16.7% and 84.6%, respectively; p = 0.002). Within the steroid group, the incidence of developing secondary complications was also markedly lower than that in the non-steroid group. Conclusions In patients afflicted with non-severe COVID-19, the employment of low-dose, short-course corticosteroids may confer a therapeutic advantage, significantly curtailing the mortality rate, the length of hospital stay, and the risk of developing secondary complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and Efficacy of Low-Dose Corticosteroids in Patients With Non-severe Coronavirus Disease 2019: A Retrospective Cohort Study

Almas¹,

Ehtesham²,

Khan³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Supplemental oxygen is the initial treatment for respiratory impairment, while patients with continued respiratory distress or respiratory failure may require noninvasive positive pressure ventilation and mechanical ventilation [ 21 ]. Corticosteroids have also shown promise in the management of COVID-19 [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Biology of COVID-19 and related viruses: Epidemiology, signs, symptoms, diagnosis, and treatment

Kaye

Cornett

Brondeel

et al. 2021

Best Practice & Research Clinical Anaesthesiology

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Coronaviruses belong to the family Coronaviridae order Nidovirales and are known causes of respiratory and intestinal disease in various mammalian and avian species. Species of coronaviruses known to infect humans are referred to as human coronaviruses (HCoVs). While traditionally, HCoVs have been a significant cause of the common cold, more recently, emergent viruses including severe acute respiratory syndrome coronavirus (SARS-CoV-2) has caused a global pandemic. Here, we discuss COVID-19 biology, pathology, epidemiology, signs and symptoms, diagnosis, treatment, and recent clinical trials involving promising treatments.

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“…We now know that hydroxychloroquine does not reduce the risk of death in hospitalized COVID-19 patients, 13 and alternatively steroids are of benefit in reducing mortality in severe cases. 14,15 This everchanging paradigm of how to treat COVID-19 patients can be exciting to some, but also perplexing and uncomfortable for hospital workers, family members, and patients.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of COVID-19 in New Orleans, Louisiana: Highlighting the Complexities of Prognostication in a Critically Ill Patient

Lerner

Burke

McCall

et al. 2020

Palliative Medicine Reports

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Palliative care teams and intensive care teams have experience providing goals-of-care guidance for critically ill patients and families. Critical coronavirus disease 2019 (COVID-19) infection is defined as infection requiring intensive care unit care, respiratory support, and often multiorgan involvement. This case presents a 53-yearold critically ill COVID-19 patient in multisystem organ failure who appeared hours from death despite best medical efforts. Comfort-focused care and compassionate extubation were offered after all medical teams felt near certain that death was imminent. Overnight, while options were being considered by the family, the patient began to markedly improve hemodynamically and was extubated several days later. Weeks later, the patient survived the hospital stay and was discharged to rehabilitation. After rehabilitation he returned home, able to walk, communicate freely, and independently perform all activities of daily living. Dialysis was no longer necessary and was stopped. The challenges of assisting in goals-of-care conversations for patients with serious COVID-19 infection are discussed.

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Steroids in COVID-19: An overview

Cited by 38 publications

References 23 publications

Safety and Efficacy of Low-Dose Corticosteroids in Patients With Non-severe Coronavirus Disease 2019: A Retrospective Cohort Study

Safety and Efficacy of Low-Dose Corticosteroids in Patients With Non-severe Coronavirus Disease 2019: A Retrospective Cohort Study

Biology of COVID-19 and related viruses: Epidemiology, signs, symptoms, diagnosis, and treatment

A Case Report of COVID-19 in New Orleans, Louisiana: Highlighting the Complexities of Prognostication in a Critically Ill Patient

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