Use of corticosteroids in the treatment of patients with COVID-19
Keywords:
ADRENAL CORTEX HORMONES, CORONAVIRUS INFECTIONS, COVID-19, THERAPEUTICSAbstract
Background: there is evidence in specialized literature that has led to divergent opinions on the use of corticosteroids as a therapeutic option to reduce inflammation and, ideally, fibrosis, in patients hospitalized with COVID-19.
Objective: to describe the results of published studies and updates on the use of corticosteroids as part of the treatment in patients with COVID-19.
Methods: a review of the scientific literature on the subject was carried out. Bibliographic databases were consulted in the search and analysis of information, with a predominance of the resources available from the Infomed network. Combinations of terms were used including: COVID-19, infection, corticosteroids.
Results: in patients with COVID-19, the use of corticosteroids as a therapeutic option in the early treatment of hyperinflammation is essential to reduce mortality, even when the clinical status of non-severe patients deteriorates. Prenatal corticosteroid treatment is recommended for pregnant women between 24 and 34 weeks of gestation, in case of risk of preterm delivery, provided there are no clinical signs of maternal infection. Systemic corticosteroids can be administered orally or intravenously. The data published to the present most strongly support the use of dexamethasone.
Conclusions: the consulted literature shows that systemic steroids reduce both mortality and invasive mechanical ventilation requirements in patients with severe or critical COVID-19. They do not report benefits in non-severe patients. Dexamethasone has been the most widely used.
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