5.3.4 Corticosteroids
As a class of drug that lowers inflammation in the body, corticosteroids have been utilized in several serious viral respiratory infections such as SARS-CoV and MERS-CoV with limited benefits. However, in some cases, there is proof of delayed viral clearance and increased rates of secondary infection and mortality (Russell et al., 2020). In a study of 41 COVID-19 patients, 22% were given corticosteroids, which inhibit inflammation in the lungs (Huang et al., 2020). However, according to the current WHO interim guidance, glucocorticoids are not recommended for routine treatment unless otherwise indicated, as other coronaviruses and influenza studies have identified possible injury and increased risk of death from glucocorticoid therapy (Zhou et al., 2020a). Despite the potential antiviral activity toward COVID-19, corticosteroids should not be given principally, and corticosteroid pulse therapy should be conducted with caution. In addition, corticosteroid therapy for the SARS therapy yielded adverse effects such as psychosis, diabetes, and avascular necrosis (Lee et al., 2004). In general, the treatment with corticosteroids may be harmful, but such agents can be prescribed to the right patient at the proper time.