Steroids should be avoided in the treatment of the current novel coronavirus, experts have advised.
A commentary article published in The Lancet concludes that, based on evidence from previous outbreaks of similar types of infection such as SARS, steroids provide little benefit to patients and could do more harm than good.
Steroids are often used by doctors to reduce inflammation, which is present in the lungs of patients with novel coronavirus. Lung inflammation was observed during the SARS and MERS outbreaks, which were caused by coronaviruses.
However, steroids also impair the immune system’s ability to fight viruses and other infections that often develop in patients with life-threatening illness. Experts say that, on balance, using the drugs could cause significant harm.
Considering the evidence
One retrospective study of critically-ill patients with MERS found that almost half of the people that received steroids needed additional treatments such as assistance in breathing, drugs to increase blood pressure, and a form of dialysis. Those given steroids were found to take longer to clear the virus from their bodies.
Other studies found that steroids caused harm in the SARS outbreak, with the virus still present in those who took the drugs up to three weeks after infection.
"During this current coronavirus outbreak clinicians are faced with some tough decisions on how to treat people who have been infected. After looking carefully at what evidence is available, we would advise that steroids should not be used for treatment of lung injury caused by this new virus. If steroids are used, it should be as part of a clinical trial so that we can find out if they are helping or harming patients." - Dr J. Kenneth Baillie
Lead author of the commentary article and Academic Consultant in Critical Care Medicine at University of Edinburgh
Reference: Russell, et al. (2020) Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. The Lancet. DOI: https://doi.org/10.1016/S0140-6736(20)30317-2
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