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

Matthay, M. A. / Wick, K. D.

J Clin Invest

Abstract: While corticosteroids dampen the dysregulated immune system and sometimes are prescribed as an adjunctive treatment for pneumonia, their effectiveness in the treatment of coronavirus 2019 (COVID-19) remains controversial In this issue of the JCI, Liu and ...

Abstract While corticosteroids dampen the dysregulated immune system and sometimes are prescribed as an adjunctive treatment for pneumonia, their effectiveness in the treatment of coronavirus 2019 (COVID-19) remains controversial In this issue of the JCI, Liu and Zhang et al evaluated corticosteroid treatment in more than 400 patients with severe COVID-19 The authors assessed subjects retrospectively for cardiac and liver injury, shock, ventilation, mortality, and viral clearance Corticosteroids in severe COVID-19 related acute respiratory distress syndrome (ARDS) was associated with increased mortality and delayed viral clearance Here, we consider how to reconcile the negative effects of corticosteroids revealed by Liu and Zhang et al with the favorable effects (reduced mortality) that were described in the RECOVERY trial We posit that treatment timing, dosage, and COVID-19 disease severity determine immune response and viral outcome Patients with moderate-to-severe COVID-19 pneumonia are likely to benefit from moderate dose corticosteroid treatment when administered relatively late in the disease course
Keywords covid19
Publisher WHO
Document type Article
Note WHO #Covidence: #798370
Database COVID19

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