Treatment with Corticosteroids may Link to Higher Risk of COVID-19 Disease?

Abstract

Corticosteroids are one of the important natural hormones released in the body that play a vital role in metabolism due to their intense anti-inflammatory, immunomodulatory and immune suppressive activity. These are most prescribed medications available in various dosage forms like topical formulations, inhalers and injectables. The current outbreak of corona virus disease COVID-19 became a global threat and primary concern worldwide. In respiratory patients, the use of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids exacerbate the disease symptoms of COVID-19 patients, as they are often regarded as immunosuppressive drugs. Inhaled corticosteroids (ICS) are considered as first line treatment of asthma and chronic obstructive pulmonary disease (COPD). COVID-19 disease led the upper respiratory tract illness. ICS are used in the treatment of early symptoms of COVID-19 disease in low doses. Asthmatic patients or patients with chronic obstructive lung disease, who are on regular use of ICS were found to have a low risk of early symptoms of severely ill COVID-19 disease. Although there appeared to be some evidence that corticosteroid therapy may be beneficial in treatment of corona virus disease, but it is also reported to be applicable only at the early acute phase. The literature records revealed that injectable formulations of corticosteroids are known to suppress the immunity in patients infected with SARS-CoV2. The present review is to study the different formulations of corticosteroids and their possible use in COVID-19 progression.

COVID-19 and corticosteroids: a narrative review

“…Concerning ciclesonide, the NSP15 has been shown to be its target. Budesonide and formoterol have been shown to autonomously inhibit the systemic suppressive effect of IL-6 causing short-term pulmonary (Pirzada et al 2021 ). It was observed that patients with asthma taking ICS were reported to be 49% lesser expected to develop severity consecutive to influenza A/H1/N1 contamination (Halpin et al 2020 ) suggesting a common protecting ICS property.…”