2021
DOI: 10.1007/s40121-021-00500-z
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Potential Adverse Effects of Dexamethasone Therapy on COVID-19 Patients: Review and Recommendations

Abstract: In the context of the coronavirus disease 2019 (COVID-19) pandemic, the global healthcare community has raced to find effective therapeutic agents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, dexamethasone is the first and an important therapeutic to significantly reduce the risk of death in COVID-19 patients with severe disease. Due to powerful anti-inflammatory and immunosuppressive effects, dexamethasone could attenuate SARS-CoV-2-induced uncontrolled cytokine storm, severe… Show more

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Cited by 46 publications
(35 citation statements)
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“…The efficacy of corticosteroid therapy at the dose using mg/kg based on the actual bodyweight was controversial [ 19 ]. Indeed, obesity and DM often recognized in overweight patients are the risks of severe COVID-19 according to previous reports, and hyperglycemia and infection are the major concerns related to the administration of corticosteroids [ 16 , 17 , 20 ]. Indeed, not only cytokine storm but also multiple mechanisms including respiratory dysfunction, pro-thrombotic environment, blocked autophagy, and fat deposition due to obesity are contributing to the poor prognosis of obese patients with COVID-19 [ 12 , 21 ].…”
Section: Discussionmentioning
confidence: 99%
“…The efficacy of corticosteroid therapy at the dose using mg/kg based on the actual bodyweight was controversial [ 19 ]. Indeed, obesity and DM often recognized in overweight patients are the risks of severe COVID-19 according to previous reports, and hyperglycemia and infection are the major concerns related to the administration of corticosteroids [ 16 , 17 , 20 ]. Indeed, not only cytokine storm but also multiple mechanisms including respiratory dysfunction, pro-thrombotic environment, blocked autophagy, and fat deposition due to obesity are contributing to the poor prognosis of obese patients with COVID-19 [ 12 , 21 ].…”
Section: Discussionmentioning
confidence: 99%
“…The use of corticosteroids has been connected to a potential neuropsychiatric impairment with about 2-60% of patients presenting with mood swings, depression, mania, suicidality, anxiety, confusion, and behavior changes, along with impairment of their sleep pattern ( Chen et al, 2021 ; Dubovsky, Arvikar, Stern, & Axelrod, 2012 ; Noreen, Maqbool, & Madni, 2021 ). The term “steroid psychosis,” which is often used in the literature to describe such phenomena, is considered by many rather misleading, as neuropsychiatric impairment exhibits a vast diversity of symptoms.…”
Section: Moderate Covid-19 Infectionmentioning
confidence: 99%
“…However, it has disadvantages due to its hydrophobicity, lack of selectivity, and low bioavailability, requiring high doses to reach the therapeutic level. Therefore, it may result in undesirable side effects, such as osteoporosis, increased blood sugar concentration, hypertension, and stomach and intestinal bleeding [ 5 ].…”
Section: Introductionmentioning
confidence: 99%