Corticosteroids for CAP, influenza and COVID-19: when, how and benefits or harm?
Eur Respir Rev
; 30(159)2021 Mar 31.
Article
in English
| MEDLINE | ID: covidwho-1079204
ABSTRACT
PURPOSE:
Corticosteroids have been considered in medicine for a long time, and they are broadly prescribed. In infectious diseases, corticosteroids have been regarded as a thread due to their immunosuppressive effects and therefore their anti-inflammatory properties. MAIN In recent years, there have been several studies published that aimed to determine the role of corticosteroids in patients with community-acquired pneumonia (CAP), because, despite significant advances in new antibiotics and supportive care, deaths of patients with CAP remain unacceptably high. While the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) CAP guidelines did not mention the use of corticosteroids in the management of CAP, the recently published 2019 IDSA/ATS guidelines recommended their use in patients with septic shock refractory to vasopressors and fluid resuscitation. Regarding viral infection, the use of corticosteroids in patients with influenza has shown to be associated with significantly higher mortality and higher incidence of nosocomial infection, while in patients with coronavirus disease 2019 (COVID-19) there is a good body of evidence of the benefit of corticosteroids in terms of mortality.CONCLUSIONS:
The use of corticosteroids has been considered as a potential alternative co-adjuvant treatment in patients with pneumonia. In patients with COVID-19, the evidence is quite strong and there is a clear benefit of the use of corticosteroids in those patients presenting severe forms of disease.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Adrenal Cortex Hormones
/
Community-Acquired Infections
/
Influenza, Human
/
COVID-19 Drug Treatment
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
16000617.0346-2020
Similar
MEDLINE
...
LILACS
LIS