Raju Reshma, V Prajith, Biatris Pratheeksha Sojan, J Sam Johnson Udaya Chander
College of Pharmacy, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, Tamil Nadu India.
Futur J Pharm Sci. 2021;7(1):67. doi: 10.1186/s43094-021-00217-3. Epub 2021 Mar 17.
In March 2020, the World Health Organization declared the coronavirus disease 2019 as a global pandemic. Though antiviral drugs and antimalarial drugs are considered treatment options for treating coronavirus disease 2019 (COVID-19), no specific antivirals are currently available for its treatment. Efficient use of drug discovery approaches including repurposing or repositioning of drugs used in the treatment of severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) is considered recently. The widespread application of corticosteroid therapy in COVID-19 should be backed with careful documented pragmatic research of its use in this context.
This article aims to analyze various trials registered across the globe providing an overall picture of the use of corticosteroids in the treatment of COVID-19. An extensive search was conducted on the clinical trial registries around the world to identify all the trials reporting information regarding the use of corticosteroids in COVID-19. Our initial search returned 231 trials, out of which 60 trials were finally included in the analysis. Fifty-six studies were interventional trials, and all the trials had clearly defined primary and secondary outcomes of interest, of which only 11 trials had evaluation of respiratory rate as one of their outcomes.
Few preliminary trial findings show promising results and recommend the use of methylprednisolone and dexamethasone in the severe form of the disease; however, there is insufficient data to prove its benefits over its risks. Routine use of corticosteroids should be favored only after a better insight is obtained, with the completion of these trials.
2020年3月，世界卫生组织宣布2019冠状病毒病为全球大流行病。尽管抗病毒药物和抗疟药物被视为治疗2019冠状病毒病（COVID-19）的治疗选择，但目前尚无特效抗病毒药物用于治疗。最近考虑有效利用药物研发方法，包括重新利用或重新定位用于治疗严重急性呼吸综合征冠状病毒（SARS-CoV）和中东呼吸综合征冠状病毒（MERS-CoV）的药物。皮质类固醇疗法在COVID-19中的广泛应用应以在此背景下使用的仔细记录的实用研究为依据。
本文旨在分析全球各地登记的各种试验，以全面了解皮质类固醇在治疗COVID-19中的应用情况。对世界各地的临床试验注册库进行了广泛搜索，以确定所有报告有关皮质类固醇在COVID-19中使用信息的试验。我们最初的搜索返回了231项试验，其中60项试验最终纳入分析。56项研究为干预性试验，所有试验都有明确界定的主要和次要感兴趣结局，其中只有11项试验将呼吸频率评估作为其结局之一。
少数初步试验结果显示出有希望的结果，并建议在疾病严重形式中使用甲泼尼龙和地塞米松；然而，没有足够的数据证明其益处大于风险。只有在完成这些试验并获得更好的认识后，才应支持常规使用皮质类固醇。
