使用皮质类固醇治疗可能会增加COVID-19疾病的风险?

Q. Pirzada, Somia Gul, Faizan Baig
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引用次数: 1

摘要

糖皮质激素是机体释放的重要天然激素之一,具有强烈的抗炎、免疫调节和免疫抑制作用,在机体代谢中起着重要作用。这些是最常用的处方药,有各种剂型,如外用制剂、吸入剂和注射剂。当前爆发的冠状病毒病COVID-19已成为全球威胁和全球关注的主要问题。在呼吸系统患者中,使用非甾体抗炎药(NSAIDs)和皮质类固醇会加重COVID-19患者的疾病症状,因为它们通常被视为免疫抑制药物。吸入皮质类固醇(ICS)被认为是哮喘和慢性阻塞性肺疾病(COPD)的一线治疗方法。新冠肺炎居上呼吸道疾病首位。ICS以低剂量用于治疗COVID-19疾病的早期症状。哮喘患者或慢性阻塞性肺疾病患者,经常使用ICS的患者出现重症COVID-19早期症状的风险较低。虽然似乎有一些证据表明,皮质类固醇治疗可能有利于治疗冠状病毒病,但也有报道称,它仅适用于早期急性期。文献记录显示,已知皮质类固醇注射制剂可抑制SARS-CoV2感染患者的免疫力。目前的综述是研究不同配方的皮质类固醇及其在COVID-19进展中的可能用途。
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Treatment with Corticosteroids may Link to Higher Risk of COVID-19 Disease?
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.
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