Use of glucocorticoids in the critical care setting: Science and clinical evidence

Chan, Edward D.; Chan, Michael; Chan, Mallory M.; Marik, Paul E.

doi:10.1016/j.pharmthera.2019.107428

Cited by 28 publications

(25 citation statements)

References 248 publications

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“…A recent report measuring the interval between hospital admission and two negative tests for SARS-CoV-2 RNA, at least a day apart, found some evidence that there was delayed viral clearance in patients with diabetes ( 39 ). In addition, they found evidence that the use of glucocorticoids could also delay viral clearance ( 39 ) which is significant as glucocorticoids are frequently used for patients with ARDS ( 40 ). Indeed, glucocorticoid use is known to impair glycaemic control ( 41 ) and has been reported to reduce angiotensin-(1-7)-Mas receptor expression ( 42 ).…”

Section: Obesity Diabetes Affect the Host Response To Sars-cov-2mentioning

confidence: 99%

Obesity, Diabetes and COVID-19: An Infectious Disease Spreading From the East Collides With the Consequences of an Unhealthy Western Lifestyle

et al. 2020

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The pandemic of COVID-19, caused by the coronavirus, SARS-CoV-2, has had a global impact not seen for an infectious disease for over a century. This acute pandemic has spread from the East and has been overlaid onto a slow pandemic of metabolic diseases of obesity and diabetes consequent from the increasing adoption of a Western-lifestyle characterized by excess calorie consumption with limited physical activity. It has become clear that these conditions predispose individuals to a more severe COVID-19 with increased morbidity and mortality. There are many features of diabetes and obesity that may accentuate the clinical response to SARS-CoV-2 infection: including an impaired immune response, an atherothrombotic state, accumulation of advanced glycation end products and a chronic inflammatory state. These could prime an exaggerated cytokine response to viral infection, predisposing to the cytokine storm that triggers progression to septic shock, acute respiratory distress syndrome, and multi-organ failure. Infection leads to an inflammatory response and tissue damage resulting in increased metabolic activity and an associated increase in the mechanisms by which cells ingest and degrade tissue debris and foreign materials. It is becoming clear that viruses have acquired an ability to exploit these mechanisms to invade cells and facilitate their own life-cycle. In obesity and diabetes these mechanisms are chronically activated due to the deteriorating metabolic state and this may provide an increased opportunity for a more profound and sustained viral infection.

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Section: Obesity Diabetes Affect the Host Response To Sars-cov-2mentioning

confidence: 99%

Obesity, Diabetes and COVID-19: An Infectious Disease Spreading From the East Collides With the Consequences of an Unhealthy Western Lifestyle

et al. 2020

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“…Glucocorticoids repress the transcription of proinflammatory genes [116]. They may be used in the management of sepsis and septic shock at small doses and short term [117]. Some studies show beneficial effects of glucocorticoids in the treatment of coronavirus (SARS and MERS) pneumonia [118][119][120].…”

Section: Glucocorticoidsmentioning

confidence: 99%

Implications of COVID-19 in pediatric rheumatology

Batu

Özen

2020

Rheumatol Int

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(coronavirus disease 2019) pandemic caused by SARS-CoV-2, is a global public health issue threatening millions of lives worldwide. Although the infection is mild in most of the affected individuals, it may cause severe clinical manifestations such as acute respiratory distress syndrome or cytokine storm leading to death. Children are affected less, and most experience a milder disease. As rheumatologists, we deal with the uncontrolled response of the immune system, and most of the drugs we use are either immune modulators or immunosuppressants. Thus, the rheumatologists participate in the multidisciplinary management of COVID-19 patients. On the other hand, our patients with rheumatic diseases constitute a vulnerable group in this pandemic. In this review, a systematic literature search was conducted utilizing MEDLINE/ PubMed and Scopus databases, and 231 COVID-19 patients with rheumatic diseases have been identified. Only one of these patients was a child. Among these, 9 (3.9%) died due to COVID-19. In light of the current data, the aspects of COVID-19 resembling rheumatic diseases, the possible reasons for why children are affected less severely, the hypothetic role of available vaccines in preventing COVID-19, the unique position of patients with rheumatic diseases in this pandemic, and the use of anti-rheumatic drugs in COVID-19 treatment are discussed.

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“…ниже) ассоциируется с неблагоприятным прогнозом при COVID-19 и риском развития ОРДС и сепсиса [14]. Материалы метаанализов и систематических обзоров свидетельствуют о благоприятном влиянии короткого курса ГК в низких или средних дозах на течение септического шока и ОРДС с рефрактерной гипоксемией, в том числе связанной с SARS-CoV и MERS-CoV [72][73][74][75]. В то же время имеются данные о том, что лечение ГК пациентов, страдающих MERS-CoV, не приводит к снижению летальности, вызывает увеличение вирусной нагрузки и замедление клиренса РНК MERS-CoV [66,76], а при гриппозной пневмонии может вызывать увеличение летальности [67].…”

Section: перспек тивы противовоспалительной фармакотерапииunclassified

Coronavirus Disease 2019 (Covid-19): A Rheumatologist’s Thoughts

Nasonov

2020

Naučno-praktičeskaâ revmatologiâ

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Use of glucocorticoids in the critical care setting: Science and clinical evidence

Cited by 28 publications

References 248 publications

Obesity, Diabetes and COVID-19: An Infectious Disease Spreading From the East Collides With the Consequences of an Unhealthy Western Lifestyle

Obesity, Diabetes and COVID-19: An Infectious Disease Spreading From the East Collides With the Consequences of an Unhealthy Western Lifestyle

Implications of COVID-19 in pediatric rheumatology

Coronavirus Disease 2019 (Covid-19): A Rheumatologist’s Thoughts

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