tetano
Editor, Senior Moderator
Endocr Pract
. 2022 Jul 20;S1530-891X(22)00565-1.
doi: 10.1016/j.eprac.2022.07.006. Online ahead of print.
New insights on Effects of Glucocorticoids in SARS-CoV-2 infection
Elena Chertok Shacham[SUP] 1 [/SUP], Avraham Ishay[SUP] 2 [/SUP]
Affiliations
Abstract
Since January 2020, the highly contagious novel coronavirus SARS-CoV-2 has caused a world pandemic. Severe coronavirus disease 2019 (COVID-19) leads to massive release of pro-inflammatory mediators, leading to diffuse damage to lung parenchyma, and development of acute respiratory distress syndrome (ARDS). Treatment with the highly potent glucocorticoid (GC), dexamethasone was found to be effective in reducing mortality in severely affected patients. In our review we discuss the regulation of the hypothalamic-pituitary-adrenal (HPA) axis in critical illness, the selection of a specific GC in critical illness- related GC insufficiency and the recent studies which investigate the HPA dysfunction in Covid-19 patients. Additionally, we focus on the mechanisms of anti-inflammatory and immunosuppressive effects of GCs, through their influence on innate and adaptive immune systems and relation of these effects in COVID-19. We also address the specific activation of the immune system with chronic endogenous glucocorticoid excess, as seen in patients with Cushing syndrome and finally we discuss the immune activation due to coronavirus infection and the possible mechanisms leading to improved outcomes of COVID-19 patients treated with GCs.
Keywords: COVID-19; Glucocorticoids; anti-inflammatory effects; hyperinflammatory syndrome.
. 2022 Jul 20;S1530-891X(22)00565-1.
doi: 10.1016/j.eprac.2022.07.006. Online ahead of print.
New insights on Effects of Glucocorticoids in SARS-CoV-2 infection
Elena Chertok Shacham[SUP] 1 [/SUP], Avraham Ishay[SUP] 2 [/SUP]
Affiliations
- PMID: 35870803
- DOI: 10.1016/j.eprac.2022.07.006
Abstract
Since January 2020, the highly contagious novel coronavirus SARS-CoV-2 has caused a world pandemic. Severe coronavirus disease 2019 (COVID-19) leads to massive release of pro-inflammatory mediators, leading to diffuse damage to lung parenchyma, and development of acute respiratory distress syndrome (ARDS). Treatment with the highly potent glucocorticoid (GC), dexamethasone was found to be effective in reducing mortality in severely affected patients. In our review we discuss the regulation of the hypothalamic-pituitary-adrenal (HPA) axis in critical illness, the selection of a specific GC in critical illness- related GC insufficiency and the recent studies which investigate the HPA dysfunction in Covid-19 patients. Additionally, we focus on the mechanisms of anti-inflammatory and immunosuppressive effects of GCs, through their influence on innate and adaptive immune systems and relation of these effects in COVID-19. We also address the specific activation of the immune system with chronic endogenous glucocorticoid excess, as seen in patients with Cushing syndrome and finally we discuss the immune activation due to coronavirus infection and the possible mechanisms leading to improved outcomes of COVID-19 patients treated with GCs.
Keywords: COVID-19; Glucocorticoids; anti-inflammatory effects; hyperinflammatory syndrome.