Corticosteroids, COVID-19 pneumonia, and acute respiratory distress syndrome

被引:39
|
作者
Matthay, Michael A. [1 ,2 ,3 ]
Wick, Katherine D. [1 ,3 ]
机构
[1] UCSF, Cardiovasc Res Inst, San Francisco, CA USA
[2] UCSF, Dept Med, San Francisco, CA USA
[3] UCSF, Dept Anesthesia, San Francisco, CA USA
来源
JOURNAL OF CLINICAL INVESTIGATION | 2020年 / 130卷 / 12期
关键词
THERAPY; CELLS; SARS;
D O I
10.1172/JCI143331
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Although corticosteroids dampen the dysregulated immune system and sometimes are prescribed as an adjunctive treatment for pneumonia, their effectiveness in the treatment of coronavirus disease 2019 (COVID-19) remains controversial. In this issue of the JCI, Liu and Zhang et al. evaluated corticosteroid treatment in more than 400 patients with severe COVID-19. The authors assessed subjects retrospectively for cardiac and liver injury, shock, ventilation, mortality, and viral clearance. Corticosteroids in severe COVID-19-related acute respiratory distress syndrome (ARDS) were associated with increased mortality and delayed viral clearance. Here, we consider how to reconcile the negative effects of corticosteroids revealed by Liu and Zhang et al. with the favorable effects (reduced mortality) that were described in the RECOVERY trial. We posit that treatment timing, dosage, and COVID-19 severity determine immune response and viral outcome. Patients with moderate-to-severe COVID-19 pneumonia are likely to benefit from moderate-dose corticosteroid treatment when administered relatively late in the disease course.
引用
收藏
页码:6218 / 6221
页数:4
相关论文
共 50 条
  • [1] Clinical Characteristics of Barotrauma in COVID-19 Pneumonia and Acute Respiratory Distress Syndrome
    Chang, S.
    Narayanan, D.
    Hwang, J.
    Chen, P.
    Parimon, T.
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2022, 205
  • [2] Acute respiratory distress syndrome in COVID-19
    Dadashzadeh, Nahid
    Farshid, Saman
    Valizadeh, Rohollah
    Nanbakhsh, Mohammad
    Rahimi, Mohsen Mohammad
    IMMUNOPATHOLOGIA PERSA, 2020, 6 (02):
  • [3] Early physiotherapy improves outcomes in Acute Respiratory Distress Syndrome in Covid-19 pneumonia
    Capitelli, Ludovica
    Prisco, Antonio
    Cuomo, Dario
    Cianci, Roberta
    Buonincontro, Miriam
    Donizzetti, Rosalba
    Squillante, Francesco
    Bocchino, Vincenzo
    EUROPEAN RESPIRATORY JOURNAL, 2021, 58
  • [4] Effect of pulsed corticosteroids and tocilizumab on hyperinflammation in COVID-19 patients with acute respiratory distress syndrome
    Aslan, Murat
    Sabaz, Mehmet Suleyman
    Yilmaz, Rabia
    Asar, Sinan
    Seker, Yasemin Tekdos
    Hergunsel, Gulsum Oya
    JOURNAL OF ACUTE DISEASE, 2021, 10 (05) : 195 - 201
  • [5] Understanding COVID-19 Acute Respiratory Distress Syndrome
    Singh, Anchit Raj
    Kumar, Raj
    Sinha, Anwita
    ANNALS OF THE AMERICAN THORACIC SOCIETY, 2022, 19 (01) : 150 - 150
  • [6] Corticosteroids in adults with acute respiratory distress syndrome and severe pneumonia
    Jayasimhan, D.
    Matthay, M. A.
    BJA EDUCATION, 2023, 23 (12) : 456 - 463
  • [7] Impact of ketamine as an adjunct sedative in acute respiratory distress syndrome due to COVID-19 Pneumonia
    Garner, Orlando
    Patterson, Jonathan
    Mejia, Julieta Munoz
    Anand, Vijay
    Deleija, Juan
    Nemeh, Christopher
    Vallabh, Meghna
    Staggers, Kristen A.
    Howard, Christopher M.
    Trevino, Sergio Enrique
    Siddique, Muhammad Asim
    Morgan, Christopher K.
    RESPIRATORY MEDICINE, 2021, 189
  • [8] Effect of the prone position on recruitability in acute respiratory distress syndrome due to COVID-19 pneumonia
    Emgin, Omer
    Rollas, Kazim
    Yeniay, Hicret
    Elve, Rengin
    Guldogan, Isil Kose
    REVISTA DA ASSOCIACAO MEDICA BRASILEIRA, 2023, 69 (05):
  • [9] Bilateral retinal hemorrhage after acute respiratory distress syndrome (ARDS) with COVID-19 pneumonia
    Peschke, P.
    Weinand, F.
    OPHTHALMOLOGIE, 2023, 120 (06): : 652 - 655
  • [10] The Potential of Cannabidiol for Acute Respiratory Distress Syndrome in COVID-19
    Azimi, Saeid
    Saghafi, Fatemeh
    Mohammadi, Mohammad Hossein
    Moghimi, Mohammad Hossein
    Akhavan, Seyed Ali
    Khataminia, Masoud
    Shirvani, Maria
    Sohrevardi, Seyed Mojtaba
    Jamialahmadi, Tannaz
    Sahebnasagh, Adeleh
    Sahebkar, Amirhossein
    CURRENT PHARMACEUTICAL DESIGN, 2023, 29 (29) : 2291 - 2296