In an effort to mitigate the coronavirus pandemic and save as many lives as possible, medical experts and researchers are leaving no stone unturned in their pursuit of successful treatments. One seemingly unlikely therapy has received attention recently for its potential to help or hurt COVID-19 patients: corticosteroids.
What Are Corticosteroids?
Corticosteroids are powerful drugs used to relieve inflammation in the body. They work by mimicking the effects of natural cortisol hormones produced by the adrenal glands in the body. This increase in hormonal activity automatically suppresses the immune system and thereby reduces inflammation.
Best known in the U.S as prednisone and cortisone, corticosteroids have long been used to treat a variety of inflammation-related diseases, including;
- Chronic obstructive pulmonary disease
- Rheumatoid arthritis
Since corticosteroids also suppress the immune system, they have become a popular, fast-acting treatment for autoimmune diseases like multiple sclerosis (MS), lupus, and Addison’s disease.
With such a long history of use in the United States, corticosteroids are available in many generic forms, including prednisolone, methylprednisolone, and hydrocortisone. They’re available in nearly every drug from, including tablets, capsules, eye drops, lotions, gels, sprays, and injections.
Unfortunately, long-term use of corticosteroids is linked to a number of side effects. Acne, weight gain, mood disorders, liver damage, and cataracts are all linked to ongoing corticosteroid use.
Do Corticosteroids Improve or Exacerbate COVID-19?
The impact of corticosteroids on COVID-19 is not yet fully understood, but researchers are in the process of exploring its effects on infected patients from two different perspectives.
First, researchers are working to understand if an early 3 to 7 day course of corticosteroid treatment may help patients with moderate to severe COVID-19. The progression of coronavirus is associated with inflammation, which prompted experts to examine the potential role of early corticosteroid therapy to minimize inflammation. In one study sponsored by Henry Ford Health System in Michigan, researchers discovered that patients treated with an early short course of methylprednisolone experienced “reduced escalation of care and improved clinical outcomes.”
On the other hand, endocrinologists have warned of potential harm to long-term corticosteroid users who become infected with COVID-19. According to Ursula Kaiser, MD, chief of the division of endocrinology, diabetes, and hypertension at Brigham and Women’s Health in Boston, “Corticosteroids may suppress the immune system, which could increase the risk of becoming infected with COVID-19.”
Multiple clinical trials are currently exploring the impacts of corticosteroid therapy in coronavirus patients. One systematic review and clinical perspective published in the European Respiratory Journal in April stated, “There is no evidence to support the withdrawal of [corticosteroids] in patients treated with these drugs, and to do so is likely harmful. Patients with asthma and COPD who are stable while using ICS should continue on their treatment.”
As with any large scale medical crisis, experts have differing opinions on the safety and efficacy of corticosteroids and their applications to the COVID-19 pandemic. This is why it’s so important for clinical trials currently in their early stages to continue to comprehensively examine this issue and help medical experts formulate informed recommendations.