Arch Acad Emerg Med . Corticosteroid Therapy in Management of Myocarditis Associated with COVID-19; a Systematic Review of Current Evidence

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Arch Acad Emerg Med


. 2021 Apr 16;9(1):e32.
doi: 10.22037/aaem.v9i1.1153. eCollection 2021.
Corticosteroid Therapy in Management of Myocarditis Associated with COVID-19; a Systematic Review of Current Evidence


William Kamarullah ¹ , Nurcahyani ¹ , Claudia Mary Josephine ¹ , Rachmatu Bill Multazam ¹ , Aqila Ghaezany Nawing ¹ , Surya Dharma ²



Affiliations

• PMID: 34027427
• PMCID: PMC8126353
• DOI: 10.22037/aaem.v9i1.1153

Abstract

Introduction: Myocarditis in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seems to be associated with a higher mortality rate. This study aims to summarize the latest evidence on whether the use of corticosteroids in patients with myocarditis associated with COVID-19 is necessary.
Methods: We performed an extensive search using a combination of search terms in PubMed, Europe PMC, ProQuest, EBSCOhost, and Google Scholar up to January 2021. Full-text articles that met the predefined inclusion criteria were included in the present study.
Results: The full-texts of 18 articles have been reviewed. Thirteen out of the eighteen (72%) patients who got corticosteroid administration experienced major clinical improvements during follow-up while the other five (28%) were experiencing uneventful events. The mean age of the reported patients was 47.8±13.2 years. There was no gender predominance. Most of the reported cases were from USA (39%) followed by Spain, China, and UK (11% each), while Brazil, Colombia, France, Belgium, and Italy contributed one case each. Various corticosteroids were used but the most commonly applied were methylprednisolone (89%), hydrocortisone (5.5%), and prednisolone (5.5%). The most common route of administration among the studies was intravenous administration and the duration of treatment varied between one and fourteen days.
Conclusion: A review of the currently available literature shows that with the use of corticosteroid agents in treating myocarditis associated with COVID-19, favorable outcomes are attainable. Well-established randomized clinical trials are needed to evaluate the efficacy and safety of using corticosteroids in this condition.

Keywords: COVID-19; adrenal cortex hormones; drug therapy; myocarditis.