Journal
EXCLI JOURNAL
Volume 20, Issue -, Pages 339-365Publisher
EXCLI JOURNAL MANAGING OFFICE
DOI: 10.17179/excli2020-3196
Keywords
COVID-19; cytokine storm; corticosteroid therapy; SARS-CoV-2; adverse effects
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The emergence of the novel coronavirus sparked numerous clinical trials globally in search of effective drugs and treatment protocols; Corticosteroids can suppress inflammation during COVID-19 infection, but also come with a range of side effects; Certain corticosteroids like methylprednisolone and dexamethasone have shown significant efficacy, particularly for COVID-19 patients on mechanical ventilation.
In December 2019, a cluster of pneumonia caused by a novel coronavirus (2019-nCoV), officially known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, Hubei province, China. Cytokine storm is an uncontrolled systemic inflammatory response resulting from the release of large amounts of pro-inflammatory cytokines and chemokines that occurs at phase 3 of viral infection. Such emergence led to the development of many clinical trials to discover efficient drugs and therapeutic protocols to fight with this single-stranded RNA virus. Corticosteroids suppress inflammation of the lungs during the cytokine storm, weaken immune responses, and inhibit the elimination of pathogen. For this reason, in COVID-19 corticosteroid therapy, systemic inhibition of inflammation is observed with a wide range of side effects. The present review discusses the effectiveness of the corticosteroid application in COVID-19 infection and the related side effects of these agents. In summary, a number of corticosteroids, including and especially methylprednisolone and dexamethasone, have demonstrated remarkable efficacy, particularly for COVID-19 patients who underwent mechanical ventilation.
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