Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019
Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019
Authors: Villar, Jesús MD, PhD1–3; Confalonieri, Marco MD4; Pastores, Stephen M. MD, MACP, FCCP, FCCM5; Meduri, G. Umberto MD6,,7
Abstract
In December 2019, pneumonia associated with the novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. On March 14, 2020, the World Health Organization (WHO) declared the coronavirus outbreak a pandemic with confirmed cases in 127 countries. This unprecedented load on healthcare institutions is particularly overwhelming for ICUs and medical personnel treating mechanically ventilated patients. The occurrence rate of acute respiratory distress syndrome (ARDS) with COVID-19 infection varied between 17% and 41% (1–3). ARDS may require weeks of mechanical ventilation (MV) and is associated with an unacceptably high mortality rate. Worldwide, thousands of patients are denied life-saving support for lack of mechanical ventilators. This is unprecedented global emergency without a workable solution. Thus, any intervention directed at decreasing duration of MV and mortality could have a great impact on public health and national security.
doi: 10.1097/CCE.0000000000000111
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