Journal
JOURNAL OF COMPARATIVE EFFECTIVENESS RESEARCH
Volume 9, Issue 18, Pages 1247-1254Publisher
Becaris Publishing
DOI: 10.2217/cer-2020-0146
Keywords
acute respiratory distress syndrome; ARDS; coronavirus; corticosteroids; COVID-19; dexamethasone; pneumonia
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Funding
- National Plan for Science, Technology and Innovation (MAARIFAH), King AbdulAziz City for Science and Technology, Kingdom of Saudi Arabia
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Dexamethasone was shown to decrease the mortality in coronavirus disease-2019 (COVID-19) recently. Use of corticosteroids was harmful in other coronavirus infections previously. WHO recommended against routine use of corticosteroids in COVID-19. In view of these, we reviewed the evidence about the use of corticosteroids in virus-induced acute respiratory distress syndrome (ARDS). Corticosteroids are beneficial in ARDS regardless of etiology. However, they increased the mortality rate in influenza-associated ARDS. In SARS and the Middle East respiratory syndrome, corticosteroids increased the mortality, delayed the viral clearance and increased the length of hospital stay. In the case of COVID-19, the available evidence from retrospective and observational studies is inconclusive about the corticosteroid use. Low-dose therapies appear to be effective. Evidence from a randomized control study found dexamethasone is effective in decreasing mortality in severe COVID-19 cases. More studies are needed to validate the benefit of corticosteroids in COVID-19.
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