Corticosteroid therapy in patients with severe COVID-19

Authors

DOI:

https://doi.org/10.33448/rsd-v10i1.12114

Keywords:

Coronavirus infections; COVID-19; SARS-CoV-2; Corticosteroids; Therapy; Therapeutics.

Abstract

The world panorama of disseminating the new coronavirus SARS-CoV-2 is considered a pandemic by the World Health Organization (WHO) with the risk of complications due to the imbalance of immune responses. The present study evaluated whether the use of corticosteroids has scientifically proven efficacy in treating patients with the severe form of COVID-19. It was a cross-sectional and integrative literature review from December 2019 to November 2020 after researching the PubMed, Scopus, Embase, Web of Science, and Google Scholar databases. According to the studies analyzed, positive results of corticotherapy were observed in patients with SARS-CoV-2 in the severe form of the disease. It was concluded that steroids are not indicated in the mild form of COVID-19 unless they have other comorbidities, such as chronic obstructive pulmonary disease (COPD) or asthma. Glucocorticoid therapy is relevant in the severe form of SARS-CoV-2, with short-term management and low doses being beneficial. It reduces morbidity and mortality and the length of stay in the ICU.

References

Almeida, M. Q., & Mendonca, B. B. (2020). Adrenal Insufficiency and Glucocorticoid Use During the COVID-19 Pandemic. Clinics, 75, e2022. https://doi.org/10.6061/clinics/2020/e2022.

Bocchese, N. V., Dávila, N. G., Rodrigues, M. B. M., Araújo-Neto, I., Costa, M. O., Barbalho, D. M. G., Rêgo, A. C. M., & Araújo-Filho, I. (2020). COVID-19 and Liver Injury: Hepatology Perspectives. Journal of Clinical Gastroenterology and Treatment, 6(074), 1-5. https://doi.org/10.23937/2469-584X/1510074.

Bocchese, N. V., Dávila, N. G., Rodrigues, M. B. M., Monte, R. R. L., Melo, R. C., Rêgo, A. C. M., & Araújo-Filho, I. (2020). Covid-19: Gastroenterology Perspectives. Journal of clinical gastroenterology and treatment, 6(075), 1-8. https://doi.org/10.23937/2469-584X/1510075.

Ministério da Saúde. Informe diário de evidências - Covid-19 (2020). Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Brasília, 44, 1-26, http://bvsms.saude.gov.br/bvs/publicacoes/Politica_Portugues.pdf

Dai, J., Xiong, Y., Li, H., Qian, Y., Xu, Y., Xu, Q., Yan, X., & Tang, J. (2020). Corticosteroid treatment in severe COVID-19 pneumonia: two cases and literature review. Clinical rheumatology, 39(7), 2031–2037. https://doi.org/10.1007/s10067-020-05172-7.

Dequin, P. F., Heming, N., Meziani, F., Plantefève, G., Voiriot, G., Badié, J., François, B., Aubron, C., Ricard, J. D., Ehrmann, S., Jouan, Y., Guillon, A., Leclerc, M., Coffre, C., Bourgoin, H., Lengellé, C., Caille-Fénérol, C., Tavernier, E., Zohar, S., & Giraudeau, B. CAPE COVID Trial Group and the CRICS-TriGGERSep Network (2020). Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19: A Randomized Clinical Trial. JAMA, 324(13), 1298–1306. https://doi.org/10.1001/jama.2020.16761.

Falavigna, M., Colpani, V., Stein, C., Azevedo, L. C. P., Bagattin, A. M., Brito, G. V., Chatkin, J. M., Cimerman, S., Corradi, M. F. D., Cunha, C. A., Medeiros, F. C., Junior, H. A. O., Fritcher, L. G., Gazzana, M. B., Gräf, D. D., Marra, L. P., Matuoka, J. Y., Nunes, M. S., Pachito, D. V., Pagano, C. G. M., Parreira, P. C. S., Riera, R., Junior, A. S., Tavares, B. M., Zavascki, A. P., Rosa, R. G., & Dal-Pizzol, F. (2020). Diretrizes para o tratamento farmacológico da COVID-19. Consenso da Associação de Medicina Intensiva Brasileira, da Sociedade Brasileira de Infectologia e da Sociedade Brasileira de Pneumologia e Tisiologia. Revista Brasileira de Terapia Intensiva, 32(2), 166-196. https://doi.org/10.5935/0103-507x.20200039.

Goés, A. B. M., Cardoso, B. B., Tavares, F. A. F., Monte, R. R. L., Melo, R. C., Araújo-Neto, I., Pinheiro, R. S. E., Rêgo, A. C. M., & Araújo-Filho, I. (2020). COVID-19 and Nervous System: Under Estimated Clinical and Prognostic Aspects. International journal of neurology and neurotherapy, 7(100), 1-7. https://doi.org/10.23937/2378-3001/1410100.

Halpin, D., Singh, D., & Hadfield, R. M. (2020). Inhaled corticosteroids and COVID-19: a systematic review and clinical perspective. The European respiratory journal, 55(5), 2001009. https://doi.org/10.1183/13993003.01009-2020.

Isidori, A. M., Pofi, R., Hasenmajer, V., Lenzi, A., & Pivonello, R. (2020). Use of glucocorticoids in patients with adrenal insufficiency and COVID-19 infection. The lancet. Diabetes & Endocrinology, 8(6), 472–473. https://doi.org/10.1016/S2213-8587(20)30149-2.

Kolilekas, L., Loverdos, K., Giannakaki, S., Vlassi, L., Levounets, A., Zervas, E., & Gaga, M. (2020). Can steroids reverse the severe COVID-19 induced "cytokine storm"?. Journal of medical virology, 92(11), 2866–2869. https://doi.org/10.1002/jmv.26165.

Li, H., Chen, C., Hu, F., Wang, J., Zhao, Q., Gale, R. P., & Liang, Y. (2020). Impact of corticosteroid therapy on outcomes of persons with SARS-CoV-2, SARS-CoV, or MERS-CoV infection: a systematic review and meta-analysis. Leukemia, 34(6), 1503–1511. https://doi.org/10.1038/s41375-020-0848-3.

Liu, J., Zhang, S., Dong, X., Li, Z., Xu, Q., Feng, H., Cai, J., Huang, S., Guo, J., Zhang, L., Chen, Y., Zhu, W., Du, H., Liu, Y., Wang, T., Chen, L., Wen, Z., Annane, D., Qu, J., & Chen, D. (2020). Corticosteroid treatment in severe COVID-19 patients with acute respiratory distress syndrome. The Journal of clinical investigation, 130(12), 6417–6428. https://doi.org/10.1172/JCI140617.

Mendes, J. J., Mergulhão, P., Froes, F., Paiva, J. A., & Gouveia, J. (2020). Recomendações da Sociedade Portuguesa de Cuidados Intensivos e Grupo de Infeção e Sépsis para a abordagem do COVID-19 em medicina intensiva. Revista Brasileira de Terapia Intensiva, 32(1), 2-10. https://doi.org/10.5935/0103-507x.20200002.

Monte, R. R. L., Tavares, F. A. F., Cardoso, B. B., Goes, A. B. M., Silva, T. C. L., Silva, B. O., Araújo, Y. S. M., Rêgo, A. C. M., & Araújo-Filho, I. (2020). Covid-19 Pandemic and Health Professionals: Practical Approaches. International Journal of Critical Care and Emergency Medicine, 6(108), 1-9. https://doi.org/10.23937/2474-3674/1510108.

Pereira, A. S., Shitsuka, D. M., Pereira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed. UAB/NTE/UFSM. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1. Este e-book é gratuito.

Prescott, H. C., & Rice, T. W. (2020). Corticosteroids in COVID-19 ARDS: Evidence and Hope During the Pandemic. JAMA, 324(13), 1292–1295. https://doi.org/10.1001/jama.2020.16747.

Qin, Y. Y., Zhou, Y. H., Lu, Y. Q., Sun, F., Yang, S., Harypursat, V., & Chen, Y. K. (2020). Effectiveness of glucocorticoid therapy in patients with severe coronavirus disease 2019: protocol of a randomized controlled trial. Chinese medical journal, 133(9), 1080–1086. https://doi.org/10.1097/CM9.0000000000000791.

Recovery Collaborative Group, Horby, P., Lim, W. S., Emberson, J. R., Mafham, M., Bell, J. L., Linsell, L., Staplin, N., Brightling, C., Ustianowski, A., Elmahi, E., Prudon, B., Green, C., Felton, T., Chadwick, D., Rege, K., Fegan, C., Chappell, L. C., Faust, S. N., Jaki, T., & Landray, M. J. (2020). Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report. The New England journal of medicine, NEJMoa2021436. Advance online publication. https://doi.org/10.1056/NEJMoa2021436.

Rizk, J. G., Kalantar-Zadeh, K., Mehra, M. R., Lavie, C. J., Rizk, Y., & Forthal, D. N. (2020). Pharmaco-Immunomodulatory Therapy in COVID-19. Drugs, 80(13), 1267–1292. https://doi.org/10.1007/s40265-020-01367-z.

Santos, F. S., & Ferraz, R. R. N. (2020). Tratamentos para COVID-19: síntese de evidências. International Journal of Health Managemen Review. (2020). 6(1), 1-9. https://ijhmreview.org/ijhmreview/article/viewFile/200/135.

Selvaraj, V., Dapaah-Afriyie, K., Finn, A., & Flanigan, T. P. (2020). Short-Term Dexamethasone in Sars-CoV-2 Patients. Rhode Island medical journal (2013), 103(6), 39–43.

Tan, S., Hong, C. C., Saha, S., Murphy, D., & Hui, J. H. (2020). Medications in COVID-19 patients: summarizing the current literature from an orthopaedic perspective. International orthopaedics, 44(8), 1599–1603. https://doi.org/10.1007/s00264-020-04643-5.

Tang, C., Wang, Y., Lv, H., Guan, Z., & Gu, J. (2020). Caution against corticosteroid-based COVID-19 treatment. Lancet (London, England), 395(10239), 1759–1760. https://doi.org/10.1016/S0140-6736(20)30749-2.

Tomazini, B. M., Maia, I. S., Cavalcanti, A. B., Berwanger, O., Rosa, R. G., Veiga, V. C., Avezum, A., Lopes, R. D., Bueno, F. R., Silva, M., Baldassare, F. P., Costa, E., Moura, R., Honorato, M. O., Costa, A. N., Damiani, L. P., Lisboa, T., Kawano-Dourado, L., Zampieri, F. G., & Olivato, G. B. Coalition COVID-19 Brazil III Investigators (2020). Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial. JAMA, 324(13), 1307–1316. https://doi.org/10.1001/jama.2020.17021.

Yang, Z., Liu, J., Zhou, Y., Zhao, X., Zhao, Q., & Liu, J. (2020). The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis. The Journal of infection, 81(1), e13–e20. https://doi.org/10.1016/j.jinf.2020.03.062.

Wu, J., Huang, J., Zhu, G., Liu, Y., Xiao, H., Zhou, Q., Si, X., Yi, H., Wang, C., Yang, D., Chen, S., Liu, X., Liu, Z., Wang, Q., Lv, Q., Huang, Y., Yu, Y., Guan, X., Li, Y., Nirantharakumar, K., & Xiao, H. (2020). Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China. The Journal of clinical endocrinology and metabolism, 105(12), 627. https://doi.org/10.1210/clinem/dgaa627.

Zha, L., Li, S., Pan, L., Tefsen, B., Li, Y., French, N., Chen, L., Yang, G., & Villanueva, E. V. (2020). Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19). The Medical journal of Australia, 212(9), 416–420. https://doi.org/10.5694/mja2.50577.

Zhang, J., Lee, K. S., Ang, L. W., Leo, Y. S., & Young, B. E. (2020). Risk Factors for Severe Disease and Efficacy of Treatment in Patients Infected With COVID-19: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 71(16), 2199–2206. https://doi.org/10.1093/cid/ciaa576.

Zhao, J. P., Hu, Y., Du, R. H., Chen, Z. S., Jin, Y., Zhou, M., Zhang, J., Qu, J. M., & Cao, B. (2020). Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases, 43(0), E007. Advance online publication. https://doi.org/10.3760/cma.j.issn.1001-0939.2020.0007.

Zhou, W., Liu, Y., Tian, D., Wang, C., Wang, S., Cheng, J., Hu, M., Fang, M., & Gao, Y. (2020). Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia. Signal transduction and targeted therapy, 5(1), 18. https://doi.org/10.1038/s41392-020-0127-9.

Downloads

Published

31/01/2021

How to Cite

DANTAS, T. C. de A. .; GOMES, A. C. A. .; LIMA, I. P. C. .; LUCAS , B. B. .; AGUIAR, M. R. de .; CAVALCANTI, T. C. de H. .; PINHEIRO, F. I. .; RÊGO, A. C. M. .; ARAÚJO-FILHO, I. Corticosteroid therapy in patients with severe COVID-19. Research, Society and Development, [S. l.], v. 10, n. 1, p. e58910112114, 2021. DOI: 10.33448/rsd-v10i1.12114. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/12114. Acesso em: 21 nov. 2024.

Issue

Vol. 10 No. 1

Section

Review Article

License

Copyright (c) 2021 Thiago Costa de Araújo Dantas; Andriny Cunha Apoliano Gomes; Ikaro Peixoto Correia Lima; Beatriz Bispo Lucas ; Mateus Rodrigues de Aguiar; Taiza Carvalho de Holanda Cavalcanti; Francisco Irochima Pinheiro; Amália Cinthia Meneses Rêgo; Irami Araújo-Filho

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.