Why Corticosteroids should be avoided in the treatment of the current coronavirus.

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Why Corticosteroids should be avoided in the treatment of the current coronavirus.

By Andrew Carruthers, Editor-In-Chief.

Sources: www.healthline.com & www.thelancet.com

Whilst the research is still being done on the effects of high testosterone levels and the current Coronavirus, one thing seems to be certain and that is that Corticosteroids don’t offer much support in people recovering from COVID-19.

What are corticosteroids?

Corticosteroids are a class of drug that lowers inflammation in the body. They also reduce immune system activity. Because corticosteroids ease swelling, itching, redness, and allergic reactions, doctors often prescribe them to help treat diseases like asthma, arthritis, lupus and other allergies.

Corticosteroids resemble cortisol, a hormone naturally produced by the body’s adrenal glands. The body needs cortisol to stay healthy. Cortisol is a major player in a wide range of processes in the body, including metabolism, immune response, and stress.

When are they prescribed?

Doctors prescribe corticosteroids for a number of reasons, including:

  • Addison’s disease. This occurs when your body doesn’t make enough cortisol. Corticosteroids can make up the difference.
  • Organ transplants. Corticosteroids help suppress the immune system and reduce the likelihood of organ rejection.
  • Inflammation. In cases when inflammation causes damage to important organs, corticosteroids can save lives. Inflammation occurs when the body’s white blood cells are mobilised to protect against infection and foreign substances.
  • Auto-immune diseases. Sometimes the immune system doesn’t work correctly, and people develop inflammatory conditions that cause damage instead of protection.Corticosteroids decrease the inflammation and prevent this damage. They also affect how white blood cells work and reduce the activity of the immune system.

Corticosteroids are also used in the treatment of:

  • asthma
  • hay fever
  • hives
  • chronic obstructive pulmonary disease (COPD)
  • lupus
  • inflammatory bowel disease
  • multiple sclerosis

A commentary article published in The Lancet concludes that, based on evidence from previous outbreaks of similar types of infection such as SARS, corticosteroids provide little benefit to patients and could do more harm than good. They say that clinicians should still administer the treatment for conditions such as asthma and other inflammatory diseases.

Corticosteroids are often used by doctors to reduce inflammation, which is present in the lungs of patients with novel coronavirus. Lung inflammation was observed during the SARS and MERS outbreaks, which were caused by coronaviruses.

However, corticosteroids also impair the immune system’s ability to fight viruses and other infections that often develop in patients with life-threatening illness. Experts say that, on balance, using the drugs could cause significant harm.

One retrospective study of critically-ill patients with MERS found that almost half of the people that received steroids needed additional treatments such as assistance in breathing, drugs to increase blood pressure, and a form of dialysis. Those given corticosteroids were found to take longer to clear the virus from their bodies.

Other studies found that corticosteroids caused harm in the SARS outbreak, with the virus still present in those who took the drugs up to three weeks after infection.

Dr J. Kenneth Baillie, lead author of the commentary article and Academic Consultant in Critical Care Medicine at University of Edinburgh, said: “During this current coronavirus outbreak clinicians are faced with some tough decisions on how to treat people who have been infected. After looking carefully at what evidence is available, we would advise that corticosteroids should not be used for treatment of lung injury caused by this new virus. If corticosteroids are used, it should be as part of a clinical trial so that we can find out if they are helping or harming patients.”

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