Effectiveness of corticosteroids in the treatment of patients with Covid 19

Abstract

The COVID-19 pandemic caused by the SARS-CoV-2 virus has emerged as one of the most significant health crises of the 21st century, with a devastating impact on global health. Understanding the disease pathogenesis and finding effective treatment strategies are crucial to mitigate its mortality rate. COVID-19 exhibits a biphasic illness, characterized by a viral response phase followed by a hyperinflammatory response phase, also known as the cytokine storm. This cytokine storm, rather than direct viral activity, has been identified as the major contributor to the high mortality associated with severe cases.
 In this article, we explore the effectiveness of corticosteroids in managing the cytokine storm and reducing mortality in COVID-19. Corticosteroids have been extensively studied for their immunosuppressive properties and have shown potential in suppressing the hyperinflammatory response associated with the disease. The RECOVERY trial, a large-scale multicenter clinical trial conducted in the UK, demonstrated a significant reduction in mortality with the use of corticosteroids, particularly in critically ill patients requiring invasive mechanical ventilation.
 However, the timing of corticosteroid therapy initiation is crucial, as early administration or use in milder cases may not yield the same benefits and could potentially increase mortality. Current evidence suggests that corticosteroids should be reserved for hospitalized patients with severe COVID-19, specifically those requiring oxygen therapy or invasive mechanical ventilation. In contrast, corticosteroid therapy has shown limited or even detrimental effects in non-severe cases.