FIRST LINE TREATMENT BY CORTICOSTEROIDS IN SEVERE COVID-19 MANIFESTATIONS

Sudip Guchhait, Soumi Das, Ishita Mitra, Shoubhik Mazumder, Dr. Dhrubo Jyoti Sen* and Dr. Dhananjoy Saha

ABSTRACT

The SARS-CoV-2 pandemic has introduced the medical community to a lung disease heretofore unknown to most clinicians. Coronavirus disease 2019 (COVID-19) pneumonia, firstly reported in Wuhan, Hubei province, China, has rapidly spread around the world with high mortality rate among critically ill patients. In much of the discourse about COVID-19 lung disease, the more familiar clinical entity of ARDS has been used as the guiding paradigm. Reflecting on studies in ARDS, particularly that due to influenza, and on data from the SARS-CoV and MERS epidemics, many authorities, including within the discipline of infectious diseases, were initially passionate in their opposition to the use of corticosteroids for lung involvement in COVID-19. Those patients usually underwent a stage of excessive inflammation before developing acute respiratory distress syndrome. In this study, we test the hypothesis that short-term, low-to-moderate-dose corticosteroids would benefit patients when used in the early phase of excessive inflammation, namely, the therapeutic window.

Keywords: Corticosteroids,covid-19,SARS-CoV, ARDS, HRCT, GGO, HRCT, CRP,TNF.