Use of glucocorticoids in SARS CoV 2 infection: pros and cons

Abstract

Treatment of SARS CoV-2 infection is a major problem in contemporary medicine caused by the absence of specifi c antiviral drugs. Attempts to use many groups of drugs have had some successes and failures. Th e pathophysiological approach to the rationality of drug use is the basis of the eff ectiveness and safety of treatment. Glucocorticoids are a group of drugs capable of solving health problems in serious and critical situations. Physicians, despite the absence of evidence-based data, continue to use corticosteroids in critical situations based on pharmacological properties and experience. In SARS CoV-2 infection initially, at the beginning of the pandemic, the use of glucocorticoids was not recommended, and later, based on clinical studies, the World Health Organization issued a series of recommendations regarding the rationality of their use through an individualized approach. Th e latter involves determining the timing of initiation, selection of the drug, doses and duration of treatment. Th e key moment in this context is the time of the onset of the cytokine storm (the second week aft er the onset of symptoms) on which the administration of glucocorticoids is directed.