Exploitation of steroids in coronavirus disease 2019: An overview

Abstract

Abstract Corticosteroids, more specifically glucocorticoids, are one of the most prescribed drugs. Corticosteroids are adrenal hormones that serve significant physiologic activities such as modulating glucose metabolism, protein catabolism, calcium metabolism, bone turnover control, immunosuppression, and downregulation of the inflammatory cascade. Corticosteroids are regarded as life-saving due to their various effects and have been used therapeutically to treat a broad range of autoimmune, rheumatologic, inflammatory, neoplastic, and viral illnesses. However, the therapeutic benefits of glucocorticoids are restricted by their adverse effects. The most serious side effects of corticosteroids are associated with the use of higher doses for longer periods and over the counter medicine availability in specific pharmacies, which leads to dependency, as well as its usage in mild and moderate server instances, which is contrary to guidelines. In recent times, the use of corticosteroids has been multiplied with the emergence of the coronavirus disease 2019 (COVID-19) pandemic. WHO and the standard guidelines have recommended the usage of corticosteroids in critically ill COVID-19 patients, but their usage in mild and moderate cases caused more harm than benefit. This illicit usage has resulted in the development of opportunistic fungal illnesses such as mucormycosis, posing an extra risk to patients in terms of quality of life and finances. Other adverse effects of systemic corticosteroids include morphological changes, increased blood sugar levels, delayed wound healing, infections, decreased bone density, truncal obesity, cataracts, glaucoma, blood pressure abnormalities, and muscle fiber atrophy. In this review, we want to discuss the significance and detrimental effects of corticosteroids emphasizing on recent times, that is, COVID-19. Anabolic-androgenic steroids are the best-studied class of APEDs (appearance and performance-enhancing drugs). Anabolic steroids increase lean muscle mass when used in conjunction with weight training. The aim, for nonathlete weightlifters is typically the improvement of appearance. The vast majority of people who misuse steroids are male nonathlete weightlifters in their 20s or 30s.