Dexamethasone for the Treatment of Coronavirus Disease (COVID-19): a Review
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COVID-19
Dexamethasone for the Treatment of Coronavirus Disease (COVID-19) : a Review Mukhtar H. Ahmed 1
&
Arez Hassan 2
Accepted: 20 October 2020 # Springer Nature Switzerland AG 2020
Abstract The World Health Organization (WHO) declared COVID-19 (novel coronavirus) as a global pandemic in the middle of March 2020, after the disease spread to more than 150 countries and territories leading to tens of thousands of cases within a couple of months. To date, there are no effective pharmaceutical treatments available. As well as that, the novel vaccines have not yet been approved as establishing their efficacy will take time. This study aims to summarize the evidence regarding corticosteroids such as dexamethasone for the treatment of COVID-19. Electronic searches were conducted on 7 September 2020 on Google Scholar database, MEDLINE and PubMed. A further search was conducted on the World Health Organization’s COVID-19 research article database. The findings of recent investigations that proved, both, the in vitro and in vivo activity of corticosteroids against COVID-19 and other coronavirus-related pneumonia were discussed. Low doses of corticosteroids (dexamethasone) could reduce the mortality in patients with severe COVID-19 disease; however, they had no effect on the mortality rate of those patients with a mild form of the condition. Moreover, the liberal use of corticosteroids was not advocated for, as high doses of the drug can cause more harm than good. Keywords Coronaviruses . SARS-CoV-2 . Corticosteroids . COVID-19 . Dexamethasone . In vivo
Introduction In December 2019, a new pneumonia-like disease emerged in Wuhan, China. The clinical features of the patients, who were confirmed to be infected with the novel coronavirus (SARSCoV-2), included a dry cough, fever and dyspnoea with lower respiratory tract involvement [1]. Subsequently, person-toperson transmission occurred [2]. The virus then rapidly spread to over 200 countries around the world, resulting in 27 million confirmed cases and 883,000 deaths globally according to a report issued by WHO on the 7th of September 2020. The COVID-19 pandemic is considered the most severe global public health crisis since the influenza outbreak in 1918. Coronaviruses (CoV) are enveloped viruses that possess
This article is part of the Topical Collection on Covid-19
a single-stranded, positive-sense RNA with a genome ranging from 26 to 32 kb, the largest among all recognized RNA viruses [3]. Phylogenetically, these viruses can be classified into four genera: α-coronavirus, β-coronavirus, γ-coronavirus, and δ-coronavirus. Among these genera, the αcoronaviruses and β-coronaviruses mainly infect mammals, and generally lead to respiratory disease in humans and gastritis in animals. Contrastingly, the γ-coronaviruses and δcoronaviruses are able to infect birds [4]. Currently, there are many strains of coronaviruses that infect humans: HCoVHKU1, HCoV-NL63, HCoV-229E, SARS-CoV and MERS-CoV [5]. SARS-CoV-2, which is also a strain, has recently been investigated in 2019. Re
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