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Steroids could impair defence against coronavirus

Steroids should be avoided in the treatment of the current novel coronavirus, experts have advised.

Steroids could do more harm than good for coronavirus

Based on evidence from previous outbreaks of similar types of infection such as SARS , steroids provide little benefit to patients and could do more harm than good, scientists conclude in a commentary article published in The Lancet.

Steroids impair the immune system’s ability to fight viruses and other infections that often develop in patients with life-threatening illness.

They say that clinicians should still administer the treatment for conditions such as asthma and other inflammatory diseases.

Lung inflammation

Steroids are often used by doctors to reduce inflammation, which is present in the lungs of patients with novel coronavirus. Lung inflammation was observed during the SARS and MERS outbreaks, which were caused by coronaviruses.

However, experts say that, on balance, using the drugs could cause significant harm.

Considering the evidence

One retrospective study of critically-ill patients with MERS found that almost half of the people that received steroids needed additional treatments such as assistance in breathing, drugs to increase blood pressure, and a form of dialysis. Those given steroids were found to take longer to clear the virus from their bodies. 

Other studies found that steroids caused harm in the SARS outbreak, with the virus still present in those who took the drugs up to three weeks after infection.  

During this current coronavirus outbreak clinicians are faced with some tough decisions on how to treat people who have been infected. After looking carefully at what evidence is available, we would advise that steroids should not be used for treatment of lung injury caused by this new virus. If steroids are used, it should be as part of a clinical trial so that we can find out if they are helping or harming patients.

Dr Kenneth BaillieLead author, Senior Clinical Research Fellow in Anaesthesia & Critical Care, Centre for Inflammation Research and the Roslin Institute, University of Edinburgh

** The Roslin Institute receives strategic investment funding from the Biotechnology and Biological Sciences Research Council and it is part of the University of Edinburgh’s Royal (Dick) School of Veterinary Studies. **

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