Faculdade de Medicina de Campos, FMC, Fundação Benedito Pereira Nunes, Campos dos Goytacazes, Rio de Janeiro, Brazil.
3 Federal University of Uberlandia, Department of Pharmacology, Uberlândia, MG, Brazil.
Pharmacol Rep. 2021 Jun;73(3):728-735. doi: 10.1007/s43440-021-00225-3. Epub 2021 Mar 5.
Coronavirus disease 2019 (COVID-19) is a viral pneumonia that can lead to acute respiratory distress syndrome (ARDS). Until the commercialization of a vaccine, pharmacological treatment still represents an important strategy to fight against the ongoing pandemic. Glucocorticoids (GC) were widely used in the past coronavirus pandemics and have been used against the coronavirus 2 severe acute respiratory syndrome (SARS-CoV-2). This article aimed to review the studies that described the treatment with GC in COVID-19 patients. Randomized or nonrandomized clinical trials and retrospective or prospective-controlled longitudinal studies were screened for this systematic review. Studies in English, Portuguese, and Spanish published since 2019, with participants of any clinical status, geographic location, age, and sex were included. The most significant interest was related to the length of stay, radiological profile changes, viremia, and mortality. The research was done electronically on the Pubmed database using the following terms: "corticosteroids", "glucocorticoids", "dexamethasone", "methylprednisolone", "COVID-19", "SARS- CoV-2", "ADRS". We identified 6332 publications, and at the end, 14 retrospective observational studies that met all the inclusion criteria were selected. These studies included only patients infected with SARS-CoV-2 confirmed by RT-PCR, involving 2,713 participants. The results showed great heterogeneity in their designs and results, which precludes a reliable conclusion on the use of GCs in the treatment of COVID-19.
新型冠状病毒病 2019(COVID-19)是一种病毒性肺炎,可导致急性呼吸窘迫综合征(ARDS)。在疫苗商业化之前,药物治疗仍然是对抗当前大流行的重要策略。糖皮质激素(GC)在过去的冠状病毒大流行中被广泛使用,并已用于对抗新型冠状病毒 2 严重急性呼吸综合征(SARS-CoV-2)。本文旨在综述描述 COVID-19 患者使用 GC 治疗的研究。本系统评价筛选了 2019 年以来发表的随机或非随机临床试验和回顾性或前瞻性对照纵向研究。纳入的研究为英语、葡萄牙语和西班牙语,参与者的临床状态、地理位置、年龄和性别不限。最关注的是住院时间、影像学特征变化、病毒血症和死亡率。研究通过 Pubmed 数据库电子检索,使用的术语有“corticosteroids”“glucocorticoids”“dexamethasone”“methylprednisolone”“COVID-19”“SARS-CoV-2”“ARDS”。共检索到 6332 篇文献,最终筛选出 14 项符合所有纳入标准的回顾性观察性研究。这些研究仅纳入了通过 RT-PCR 确诊的 SARS-CoV-2 感染患者,共涉及 2713 名参与者。结果显示,这些研究的设计和结果存在很大的异质性,因此无法就 GC 在 COVID-19 治疗中的应用得出可靠的结论。