Can steroids reverse the severe COVID-19 induced "cytokine storm"?
Can steroids reverse the severe COVID-19 induced "cytokine storm"?
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DOI：
10.1002/jmv.26165
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发表时间：
2020-06-29
影响因子：
12.7
通讯作者：
Gaga, Mina
中科院分区：
文献类型：
--
作者：
Kolilekas, Lykourgos;Loverdos, Konstantinos;Gaga, Mina
重症冠状病毒病（COVID - 19）的特征是过度的促炎细胞因子风暴，导致急性肺损伤和急性呼吸窘迫综合征（ARDS）的发生。在重症COVID - 19肺炎及相关的高炎症综合征中，糖皮质激素的作用存在争议。我们报道了一个连续6例COVID - 19重症肺炎、ARDS以及高炎症综合征实验室指标患者的病例系列。所有患者均早期接受了短疗程糖皮质激素治疗，并比较了使用糖皮质激素前后的临床结果。所有患者均避免了插管和入住重症监护病房，ARDS在11.8天（中位数）内缓解，4例患者在17.2天（中位数）内实现病毒清除，所有患者在16.8天（中位数）内出院。早期给予短疗程糖皮质激素可改善重症COVID - 19肺炎且有免疫高反应性证据的患者的临床结局。
Severe coronavirus disease (COVID-19) is characterized by an excessive proinflammatory cytokine storm, resulting in acute lung injury and development of acute respiratory distress syndrome (ARDS). The role of corticosteroids is controversial in severe COVID-19 pneumonia and associated hyper-inflammatory syndrome. We reported a case series of six consecutive COVID-19 patients with severe pneumonia, ARDS and laboratory indices of hyper-inflammatory syndrome. All patients were treated early with a short course of corticosteroids, and clinical outcomes were compared before and after corticosteroids administration. All patients evaded intubation and intensive care admission, ARDS resolved within 11.8 days (median), viral clearance was achieved in four patients within 17.2 days (median), and all patients were discharged from the hospital in 16.8 days (median). Early administration of short course corticosteroids improves clinical outcome of patients with severe COVID-19 pneumonia and evidence of immune hyperreactivity.