Serbian Journal of Anesthesia and Intensive Therapy (Jan 2021)
Use of corticosteroids in the therapy of COVID-19 infection (corticosteroids in COVID-19 infection)
Abstract
At the end of December 2019, a certain number of patients with pneumonia of unknown etiology appeared in the Chinese city of Wuhan. The etiological agent of corona virus disease (COVID-19) was identified as a virus from the Coronaviridae family called Novel Coronavirus, or SARS-CoV-2 (Severe Acute Respiratory Coronavirus 2). COVID-19 took on the proportions of a pandemic. Therapeutic options for COVID-19 include antiviral, anticoagulant, corticosteroid, biological, antibiotic, multivitamin, symptomatic therapy, and oxygen support. Corticosteroid immunosuppressive and anti-inflammatory role is helpful for a disease with immune response dysregulation and excessive cytokine production. The effect of corticosteroids in the treatment of COVID-19 depends on disease severity, the time of initiation, and the appropriate dose. Individual risk/benefit assessment is required before initiating treatment. Corticosteroids have beneficial effects on patients on oxygen support, especially on those who are on mechanical ventilation. Their use in those with mild forms of the disease and comorbidities carries an increased risk of complications. The benefits of corticosteroids are shorter hospitalization, reduced admission in intensive care units, and reduced need for non-invasive and invasive mechanical ventilation. The results of previous research have facilitated the administration of corticosteroids in the treatment of patients with COVID-19 infection, but further research is needed to remove the existing doubts.
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