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Editorial
. 2022 Oct 20;60(4):2201220.
doi: 10.1183/13993003.01220-2022. Print 2022 Oct.

Are intravenous corticosteroid pulses superior to low dose corticosteroids in patients with severe COVID-19?

Viviane Cordeiro Veiga  1   2 , Alexandre Biasi Cavalcanti  2   3
Affiliations
Editorial

Are intravenous corticosteroid pulses superior to low dose corticosteroids in patients with severe COVID-19?

Viviane Cordeiro Veiga et al. Eur Respir J. .

Abstract

Corticosteroids were the first drugs proven to reduce mortality in Covid-19. In June 2020, the RECOVERY group announced the results of their seminal trial showing dexamethasone 6 mg per day was able to reduce 28-day mortality in hospitalized patients with Covid needing supplemental oxygen or mechanical ventilation [1]. Meta-analysis from randomized controlled trials (RCT) in Covid-19 patients confirmed RECOVERY results [2]. In those RCTs, corticosteroid doses were low (dexamethasone 6 mg per day) or intermediate (dexamethasone up to 20mg per day).

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Conflict of interest statement

Conflict of interest: The authors have nothing to disclose.

Comment on

  • Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia: a double-blind, randomised, placebo-controlled trial.
    Salvarani C, Massari M, Costantini M, Merlo DF, Mariani GL, Viale P, Nava S, Guaraldi G, Dolci G, Boni L, Savoldi L, Bruzzi P, Turrà C, Catanoso M, Marata AM, Barbieri C, Valcavi A, Franzoni F, Cavuto S, Mazzi G, Corsini R, Trapani F, Bartoloni A, Barisione E, Barbieri C, Burastero GJ, Pan A, Inojosa W, Scala R, Burattini C, Luppi F, Codeluppi M, Tarek KE, Cenderello G, Salio M, Foti G, Dongilli R, Bajocchi G, Negri EA, Ciusa G, Fornaro G, Bassi I, Zammarchi L, Aloè T, Facciolongo N. Salvarani C, et al. Eur Respir J. 2022 Oct 20;60(4):2200025. doi: 10.1183/13993003.00025-2022. Print 2022 Oct. Eur Respir J. 2022. PMID: 35361632 Free PMC article. Clinical Trial.

References

    1. Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19 [press release]. University of Oxford 2020.
    1. Sterne JAC, Murthy S, Diaz JV, et al. . Association between administration of systemic corticosteroids and mortality among critically Ill patients with COVID-19: a meta-analysis. Jama 2020; 324: 1330–1341. doi:10.1001/jama.2020.17023 - DOI - PMC - PubMed
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    1. Dafni M, Karampeli M, Michelakis I, et al. . Treatment with 3-day methylprednisolone pulses in severe cases of COVID-19 compared with the standard regimen protocol of dexamethasone. J Investig Med 2022. - PubMed
    1. López Zúñiga M, Moreno-Moral A, Ocaña-Granados A, et al. . High-dose corticosteroid pulse therapy increases the survival rate in COVID-19 patients at risk of hyper-inflammatory response. PLoS One 2021; 16: e0243964. doi:10.1371/journal.pone.0243964 - DOI - PMC - PubMed