糖皮质激素治疗COVID-19危重患者疗效观察

L. L., Gao Y, Z. R, Li F, Xiao C, Zhai S, L. C, H. Q., Zhong B, L. J., Y. M, Y. C
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引用次数: 0

摘要

严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染的迅速传播在全球范围内造成了前所未有的公共卫生、经济和社会危机。由于没有有效清除病毒和终止传播的治疗方法,支持治疗是COVID-19的主要临床方法,包括皮质类固醇、呼吸支持和体外膜氧合治疗,而后续的药物和候选疫苗仍在研究中。COVID-19是一种两阶段疾病:在早期阶段,病毒的病理学占主导地位;在后期,免疫病理驱动疾病。低剂量地塞米松治疗通过补充内源性皮质醇活性来抑制covid -19相关免疫病理,同时避免了高剂量糖皮质激素治疗的不良反应。糖皮质激素作为抗炎佐剂的主要手段之一,其在COVID-19治疗中的作用存在争议。在此,我们通过比较不同严重程度患者接受或未接受糖皮质激素治疗的临床资料,回顾性评价糖皮质激素的治疗效果。
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Therapeutic Effect of Corticosteroids for Critical COVID-19 Patients
The rapid spread of severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection has resulted in an unprecedented public health, economic, and social crisis worldwide. As therapeutics that can effectively clear the virus and terminate transmission are not available, supportive therapeutics are the main clinical methods for Corona Virus Disease (COVID-19) including corticosteroids, respiratory support, and extracorporeal membrane oxygenation for salvage therapy, while subsequent agents and vaccine candidates are still under investigation. COVID-19 is a two-phase disease: in the early phase, the pathology of the virus dominates; in the later phase, Immunopathology drives the disease. Low-dose dexamethasone treatment suppresses COVID-19-related Immunopathology by complementing endogenous cortisol activity, while avoiding the adverse effects of high-dose glucocorticoids therapy. Corticosteroids, as one of the main means of anti-inflammatory adjuvant, are controversial about its role in the treatment of COVID-19. Here, we retrospectively evaluate the therapeutic effect of corticosteroids by comparing the clinical data of patients with or without corticosteroids therapy at different severity level.
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