Severe COVID-19 is characterized by extensive interstitial lung disease and a strong inflammatory response. Given the limited efficacy of remdesivir, the only proven antiviral, several anti-inflammatory therapies have been tested, including NSAIDs, tocilizumab and corticosteroids. Corticosteroid use is still controversial; however the RECOVERY trial demonstrated that 6 mg of dexamethasone was effective in reducing 28 days mortality in patients receiving oxygen support. Smaller studies confirmed this finding. While encouraging, the RECOVERY trial leaves open several points (choice of steroid, dosing, time of initiation). Moreover, the possible side effects of steroids can be severe. The most relevant to the matter at hand is the risk of immunosuppression and coinfection. We aim to assess the benefit/risk of high dose steroid bolus as salvage therapy for ARDS in COVID-19.
Severe COVID-19 is characterized by extensive interstitial lung disease and a strong inflammatory response. Given the limited efficacy of remdesivir, the only proven antiviral, several anti-inflammatory therapies have been tested, including NSAIDs, tocilizumab and corticosteroids. Corticosteroid use is still controversial; however the RECOVERY trial demonstrated that 6 mg of dexamethasone was effective in reducing 28 days mortality in patients receiving oxygen support. Smaller studies confirmed this finding. While encouraging, the RECOVERY trial leaves open several points (choice of steroid, dosing, time of initiation). Moreover, the possible side effects of steroids can be severe. The most relevant to the matter at hand is the risk of immunosuppression and coinfection. We aim to assess the benefit/risk of high dose steroid bolus as salvage therapy for ARDS in COVID-19.
Safety of high dose steroid boli as rescue therapy in COVID-19 patients with terminal ARDS
CUTAJAR, GIULIA
2019/2020
Abstract
Severe COVID-19 is characterized by extensive interstitial lung disease and a strong inflammatory response. Given the limited efficacy of remdesivir, the only proven antiviral, several anti-inflammatory therapies have been tested, including NSAIDs, tocilizumab and corticosteroids. Corticosteroid use is still controversial; however the RECOVERY trial demonstrated that 6 mg of dexamethasone was effective in reducing 28 days mortality in patients receiving oxygen support. Smaller studies confirmed this finding. While encouraging, the RECOVERY trial leaves open several points (choice of steroid, dosing, time of initiation). Moreover, the possible side effects of steroids can be severe. The most relevant to the matter at hand is the risk of immunosuppression and coinfection. We aim to assess the benefit/risk of high dose steroid bolus as salvage therapy for ARDS in COVID-19.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/11921