Treatment of COVID-19-exacerbated asthma: should systemic corticosteroids be used?

被引:25
|
作者
Kumar, Kartik [1 ]
Hinks, Timothy S. C. [2 ,3 ]
Singanayagam, Aran [1 ]
机构
[1] Imperial Coll London, Natl Heart & Lung Inst, London, England
[2] Univ Oxford, Nuffield Dept Med Expt Med, Oxford Biomed Res Ctr, Resp Med Unit, Oxford, England
[3] Univ Oxford, Nuffield Dept Med Expt Med, Oxford Biomed Res Ctr, Natl Inst Hlth Res, Oxford, England
基金
英国惠康基金;
关键词
asthma; corticosteroid; COVID-19; exacerbation; RHINOVIRUS; INFECTION; INFLAMMATION; RESPONSES; CYTOKINE; CELLS;
D O I
10.1152/ajplung.00144.2020
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a new rapidly spreading infectious disease. Current guidance from the World Health Organization (WHO) highlights asthmatics as a high-risk group for severe illness from COVID-19. Viruses are common triggers of asthma exacerbations and the current SARS-CoV-2 pandemic raises several questions regarding the optimum management strategies. Here, we discuss the contentious issue of whether the mainstay therapy systemic corticosteroids should be used in the routine management of COVID-19-associated asthma exacerbations. Recent guidance from the WHO has advised against the use of corticosteroids if COVID-19 is suspected due to concerns that these agents may impair protective innate antiviral immune responses. This may not be appropriate in the unique case of asthma exacerbation, a syndrome associated with augmented type 2 inflammation, a disease feature that is known to directly inhibit antiviral immunity. Corticosteroids, through their suppressive effects on type 2 inflammation, are thus likely to restore impaired antiviral immunity in asthma and, in contrast to non-asthmatic subjects, have beneficial clinical effects in the context of SARS-CoV-2 infection.
引用
收藏
页码:L1244 / L1247
页数:4
相关论文
共 50 条
  • [41] DOES THE INHALED CORTICOSTEROIDS USED IN PREVENTION OF ASTHMA AT PREGNANT WOMEN CAUSE SYSTEMIC SIDE EFFECTS?
    Martinovic, M.
    Pantovic, S.
    BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY, 2009, 105 : 87 - 87
  • [42] DEVELOPMENT OF ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS DURING TREATMENT OF SEVERE ASTHMA WITH SYSTEMIC CORTICOSTEROIDS
    CLAYTON, DE
    BUSSE, WW
    JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1981, 67 (03) : 243 - 246
  • [43] Use of Systemic Corticosteroids in Children with Asthma: Evidence of Treatment of Failure and Future Risk
    Stempel, David A.
    JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2021, 9 (04): : 1552 - 1553
  • [44] Impact of systemic corticosteroids on length of hospitalization among patients with COVID-19
    Zamarron, Ester
    Carpio, Carlos
    Villamanan, Elena
    Alvarez-Sala, Rodolfo
    Borobia, Alberto M.
    Gomez-Carrera, Luis
    Buno, Antonio
    Prados, M. Concepcion
    FARMACIA HOSPITALARIA, 2023, 47 (02) : T55 - T63
  • [45] Addition of convalescent plasma to systemic corticosteroids in early phase of COVID-19
    Yuksel, Aycan
    Ilgar, Ceren
    Agaoglu, Asya Eylul
    Akpinar, Evrim Eylem
    EUROPEAN RESPIRATORY JOURNAL, 2021, 58
  • [46] Systemic corticosteroids for management of COVID-19: Saving lives or causing harm?
    FakhriRavari, Alireza
    Jin, Stephanie
    Kachouei, Farrnam H.
    Le, Diana
    Lopez, Mireya
    INTERNATIONAL JOURNAL OF IMMUNOPATHOLOGY AND PHARMACOLOGY, 2021, 35
  • [47] Remdesivir and corticosteroids in the treatment of hospitalized COVID-19 patients
    Luís Coelho
    Fatima Falcão
    Pedro Póvoa
    Erica Viegas
    Antonio Pais Martins
    Eduarda Carmo
    Candida Fonseca
    Luis Campos
    Kamal Mansinho
    Inês Carmo
    Joana Soares
    Mariana Solano
    Dina Mendes
    Ana Cláudia Miranda
    Antonio Carvalho
    Ana Mirco
    Helena Farinha
    Isabel Aldir
    José Correia
    Scientific Reports, 13
  • [48] Calcifediol or Corticosteroids in the Treatment of COVID-19: An Observational Study
    Entrenas-Castillo, Marta
    Entrenas-Costa, Luis Manuel
    Pata, Maria P.
    Jurado-Gamez, Bernabe
    Munoz-Corroto, Cristina
    Gomez-Rebollo, Cristina
    Mira-Padilla, Estefania
    Bouillon, Roger
    Quesada-Gomez, Jose Manuel
    NUTRIENTS, 2024, 16 (12)
  • [49] Unresolved questions about the treatment of COVID-19 with corticosteroids
    Corral-Gudino, Luis
    Abadia-Otero, Jesica
    Gomez-Barquero, Julia
    MEDICINA CLINICA, 2021, 156 (03): : 143 - 144
  • [50] Remdesivir and corticosteroids in the treatment of hospitalized COVID-19 patients
    Coelho, Luis
    Falcao, Fatima
    Povoa, Pedro
    Viegas, Erica
    Martins, Antonio Pais
    Carmo, Eduarda
    Fonseca, Candida
    Campos, Luis
    Mansinho, Kamal
    Carmo, Ines
    Soares, Joana
    Solano, Mariana
    Mendes, Dina
    Miranda, Ana Claudia
    Carvalho, Antonio
    Mirco, Ana
    Farinha, Helena
    Aldir, Isabel
    Correia, Jose
    SCIENTIFIC REPORTS, 2023, 13 (01)