COVID19: Dexamethasone; death or deliverer therefrom?

Robinson, Jared; Banerjee, Indrajit; Annavarapu, Amarendra; Leclézio, Alexandra

doi:10.3126/jbs.v7i1.29853

Cited by 3 publications

(3 citation statements)

References 10 publications

(11 reference statements)

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“…On the other hand, corticosteroid therapy may worsen the diabetic control, thus creating the perfect environment for such opportunistic mucormycotic infections. Added to the negative effect that corticosteroids have on diabetic control another large drawback is the immunosuppressant nature of the drug which gives infections such as Mucormycosis another foothold for invasion [30][31][32]. Glycaemic control, discontinuation of corticosteroid therapy, thorough surgical debridement, and antifungal treatment are the current management recommendations [33].…”

Section: Corticosteroid Therapy and Concomitant Co-mycotic Infectionsmentioning

confidence: 99%

Mucormycosis and COVID-19 an epidemic in a pandemic?

Banerjee¹,

Robinson²,

Asim

et al. 2021

Nepal J Epidemiology

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Mucormycosis and aspergillosis are rare, invasive and life-threatening infections. The causative agents being namely: Aspergillus fumigatus and Rhizopus arrhizus. The case fatality rates being over 50% respectively. Invasive Aspergillosis and Mucormycosis have been established and recognized as a complication of the SARS-CoV-2 infection. These cases have been intimately linked and related to prior corticosteroid therapy. With the new B.1.617.2 and B.1.617.2.1 or AY.1 strain of the coronavirus running rampant throughout India causing unprecedented death tolls, a new crisis is evolving. Invasive “black fungus” (Mucormycosis) is creating an epidemic within a global pandemic. The unique socio-economic, genetic and health status of India’s population culminates into a melting pot which sustains the viable triad for the “black fungus” infection to gain a stronghold. Diabetes mellitus, immunosuppression and the current COVID-19 global pandemic with its massive surges in the country have produced the “perfect storm.” Eye surgeons from around India are registering a surge in invasive Mucormycosis cases with a rise in orbital compartment syndrome often calling for radical procedures such as enucleation surgeries. The “black fungus” pandemic and invasive Mucormycosis occurring in COVID-19 patients in India is a depiction of the sinister secondary infections and complications intimately linked with the virus. It is therefore of the upmost importance that countries surrounding India in particular Nepal and other Asiatic nations take great cognizance of this indolent “black fungus killer” and ensure new screening and testing protocols are put into place.

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Section: Corticosteroid Therapy and Concomitant Co-mycotic Infectionsmentioning

confidence: 99%

Mucormycosis and COVID-19 an epidemic in a pandemic?

Banerjee¹,

Robinson²,

Asim

et al. 2021

Nepal J Epidemiology

Self Cite

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“…e use of these drugs will be instrumental in the treatment and prevention of severe complications. [34,35] [Tables 1 and 2] depict the number of intervention patients, the number of control group patients, the baseline inflammatory profile, the combination of drugs prescribed, and the outcomes of the therapy in patients suffering from COVID-19. Ramiro et al conducted a randomized control trial with 86 intervention patients and 86 control group patients.…”

Section: Resultsmentioning

confidence: 99%

Pharmacotherapy of Cytokine Release Syndrome in Severe COVID-19 Patients: A Systematic Review

Robinson¹,

Banerjee²,

Leclézio³

2021

GJMPBU

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The coronavirus pandemic which spread from Wuhan China toward the latter part of 2019 has resulted in 216,303,376 confirmed cases and 4,498,451deaths deaths to date. The novelty and lack of a definitive treatment protocol for the virus and the acute respiratory distress syndrome it produces has resulted in patients being placed on artificial ventilation and most often never recovering therefrom. Very little is known about the pathophysiology of the virus and the biological mechanisms in which it disrupts to bring about the now identified wide array of clinical features which are not solely isolated to the respiratory tract. It is now an established fact however, that one of the major pathways implicated and on which often results in the death and or severe complications in COVID-19 patients is the cytokine storm. The use of new drugs to combat such a cytokine storm is thus important considering the current global COVID-19 situation so as to stop the further progression of the disease in patients and decrease both morbidity and mortality by crippling a major mechanism which hastens death in the hosts. It is, therefore, vital that a systematic analysis and review of the various therapeutic agents are undertaken to select the best drug for the treatment of patients with cytokine storm. This research aims to relate the best therapeutic regimens currently available precisely and concisely to physicians so as to ensure the best possible treatment modality is selected for each patient. An extensive review of the literature was done on the following databases: Google scholar, Trip database, EMBASE, PubMed, and PubMed Central. The keywords and the Boolean operators used for searches were “COVID-19” OR “SARS-CoV-2” AND “Therapeutics” OR “drug therapy” AND “Cytokine Release Syndrome.” The discovery and the use of such drugs, namely, Tocilizumab and potent corticosteroids such as dexamethasone and methylprednisolone in the maximum daily doses of 6 mg and 250 mg, respectively, have shown positive outcome to combat cytokine storm in severe COVID-19 patients. The rationale behind the use of these drugs being to suppress the immune system and thus decrease the detrimental cytokine cascade induced in severely ill COVID-19 patients will be instrumental in the treatment and prevention of severe complication. It is vital for the various drugs under trial and implemented in emergency use to be compared and studied so as to best select the drug which can be incorporated into a treatment regimen which is both effective and has diminished adverse effects.

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“…On the other hand, it makes the room for worsening the diabetic control, creating the ultimate environment for opportunistic infections such as mucormycosis. Adding to the immunosuppressant nature of glucocorticoids they may also provide another foothold for invasion [ 172 ]. Proper glycemic control, wise use of glucocorticoids, prompt antifungal treatment with proper surgical debridement are the recommended patterns for management [ 7 ].…”

Section: Mucormycosis and Covid-19mentioning

confidence: 99%

New Insights on Mucormycosis and Its Association With the COVID-19 Pandemic

et al. 2021

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COVID-19 continues to cause significant fatality worldwide. Glucocorticoids prove to play essential roles in COVID-19 management; however, the extensive use of steroids together with the virus immune dysregulation may increase the danger of secondary infections with mucormycosis, an angioinvasive fungal infection. Unfortunately, a definite correlation between COVID-19 and elevated mucormycosis infection cases is now clear worldwide. In this review, we discuss the historical record and epidemiology of mucormycosis as well as pathogenesis and associated host immune response, risk factors, clinical presentation, diagnosis and treatment. Special emphasis is given to its association with the current COVID-19 pandemic, including latest updates on COVID-19-associated mucormycosis cases globally, with recommendations for efficacious management.

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COVID19: Dexamethasone; death or deliverer therefrom?

Cited by 3 publications

References 10 publications

Mucormycosis and COVID-19 an epidemic in a pandemic?

Mucormycosis and COVID-19 an epidemic in a pandemic?

Pharmacotherapy of Cytokine Release Syndrome in Severe COVID-19 Patients: A Systematic Review

New Insights on Mucormycosis and Its Association With the COVID-19 Pandemic

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