Kang Mohleen, Cavallazzi Rodrigo
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, 615 Michael Street NE Suite 205, Atlanta, GA 30322, USA; Joseph Maxwell Cleland Atlanta VA Medical Center, Decatur, GA, USA.
Division of Pulmonary, Critical Care & Sleep Disorders Medicine, University of Louisville School of Medicine, 4101 East Chestnut Street, Suite 480, Louisville, KY 40202, USA.
Clin Chest Med. 2025 Mar;46(1):159-167. doi: 10.1016/j.ccm.2024.10.012. Epub 2024 Nov 16.
Glucocorticoid (GC) use is often the mainstay of treatment in many pulmonary, autoimmune, allergic, and oncologic diseases, along with organ transplantation. Short-term and long-term GC use is estimated to be around 1% to 2% worldwide. It has been associated with significant infectious complications such as streptococcus and influenza, mycobacterial infections, and opportunistic infections, specifically Pneumocystis pneumonia, invasive fungal infections, and strongyloidiasis. It is important to use minimal effective dose for the shortest duration to minimize complications. This review summarizes the prevalence of steroid prescriptions, mechanisms, manifestations, and mitigation strategies of pulmonary immunocompromise in patients on chronic and high-dose steroid therapies.
