Systemic corticosteroids in the management of covid-19 ARDS

Česká verzia

Authors: F. Keller; V. Kočí; K. Řiháková; J. Maláska; J. Stašek
Authors place of work: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Brno, Lékařská fakulta Masarykovy univerzity
Published in the journal: Anest. intenziv. Med., 32, 2021, č. 3, s. 150-155
Category: Review Article

Summary

Human coronavirus SARS-CoV-2 (Severe acute respiratory coronavirus 2), due to its ability to cause lung injury in significant percentage of patients, represents great medical and even social problem. Since the outbreak of the pandemic at the end of 2019, many new therapeutics have been tested. Unfortunatelly, real benefit in high quality studies was confirmed in just a few of them. One of these exceptions is represented by corticosteroids used in patients with advanced grade of oxygenation failure. Corticosteroids have favorable influence on lung injury and potentially facilitate reparation of pulmonary functions by modulating inflammatory response mediated through glucocorticoid receptors. Their benefit was confirmed in several randomized trials and they actually represent an integral part of complex care in those patients with pneumonia caused by SARS-CoV-2, who are in need of oxygenotherapy or mechanical ventilation. Nevertheless, uncertainty exists regarding their optimal dose in such a broad spectrum of patients. Data from former studies performed in non coronavirus patients with Acute Respiratory Distress Syndrome (ARDS) favor rather larger doses of steroids than those tested in covid-19 patients. Also optimal timing and choice of specific corticosteroid remains unknown. Ongoing clinical trials could provide answers to these relevant questions.

Keywords:

COVID-19 – ARDS – corticosteroids

Zdroje

1. Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med. 2020 Dec 17; 383(25): 2451–2460. doi: 10.1056/NEJMcp2009575. Epub 2020 May 15. PMID: 32412710.

2. Domecq JP, Lal A, Sheldrick CR, Vishakha KK, Boman K, Bolesta S, et al., COVID-19 Registry Investigator Group. Outcomes of Patients With Coronavirus Disease 2019 Receiving Organ Support Therapies: The International Viral Infection and Respiratory Illness Universal Study Registry. Crit Care Med. 2021 Mar 1; 49(3): 437–448. doi: 10.1097/CCM.0000000000004879. Erratum in: Crit Care Med. 2021 May 1; 49(5): e562. PMID: 33555777.

3. Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020 May 12; 323(18): 1824–1836. doi: 10.1001/jama.2020.6019.PMID: 32282022

4. Marshall JC, Murthy S, Diaz J, Adhikari NK, Angus DC, Arabi YM, et al. A minimal common outcome measure set for COVID-19 clinical research. The Lancet Infectious Diseases. 2020; 20(8): e192–e197. https://doi.org/10.1016/S1473-3099(20)30483-7

5. Meduri GU, Annane D, Confalonieri M, Chrousos GP, Rochwerg B, Busby A, et al. Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS. Intensive Care Medicine [online]. 2020; 46(12): 2284–2296 [cit. 2020-12-14]. Dostupné z: doi:10.1007/ s00134-020-06289-8

6. Panettieri RA, Schaafsma D, Amrani Y, Koziol-White C, Ostrom R, Tliba O. Non-genomic Effects of Glucocorticoids: An Updated View. Trends in Pharmacological Sciences [online]. 2019; 40(1): 3–49 [cit. 2020-12-14]. Dostupné z: doi:10.1016/j.tips.2018.11.002

7. The ARDS Definition Task Force. Acute respiratory distress syndrome: the Berlin definition. JAMA 2012; 307: 2526–2533. doi:10.1001/jama.2012.5669

8. Pierrakos. Acute Respiratory Distress Syndrome: Pathophysiology and Therapeutic Options. Journal of Clinical Medicine Research [online]. 2012 [cit. 2021-01-15]. Dostupné z: doi:10.4021/jocmr761w

9. Huang X, Xiu H, Zhang S, Zhang G. The Role of Macrophages in the Pathogenesis of ALI/ARDS. Mediators of Inflammation [online]. 2018; 2018: 1–8 [cit. 2021-01-15]. Dostupné z: doi:10.1155/2018/1264913

10. Matthay MA, Zemans RL. The Acute Respiratory Distress Syndrome: Pathogenesis and Treatment. Annual Review of Pathology: Mechanisms of Disease [online]. 2011; 6(1): 147– 163 [cit. 2021-01-15]. Dostupné z: doi:10.1146/annurev-pathol-011110-130158

11. Huppert L, Matthay MA, Ware L. Pathogenesis of Acute Respiratory Distress Syndrome. Seminars in Respiratory and Critical Care Medicine [online]. 2019; 40(01): 031–039 [cit. 2021-01-15]. Dostupné z: doi:10.1055/s-0039-1683996

12. Frantzeskaki F, Armaganidis A, Orfanos SE. Immunothrombosis in Acute Respiratory Distress Syndrome: Cross Talks between Inflammation and Coagulation. Respiration [online]. 2017; 93(3): 212–225 [cit. 2021-01-16]. Dostupné z: doi:10.1159/000453002

13. Matthay MA, Zemans RL, Zimmerman GA, Arabi YM, Beitler JR, Mercat A, et al. Acute respiratory distress syndrome. Nature Reviews Disease Primers [online]. 2019; 5(1): [cit. 2020-12-17]. Dostupné z: doi: 10.1038/s41572-019-0069-0

14. Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med 2020; published online April 14. doi: 10.1007/s00134-020-06033-2.

15. Fan E, Beitler JR, Brochard L, Calfee CS, Ferguson ND, Slutsky AS, et al. COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?. Lancet Respir Med. 2020; 8(8): 816–821. doi: 10.1016/S2213-2600(20)30304-0

16. Meduri GU, Muthiah MP, Carratú P, Eltorky M, Chrousos GP. Nuclear Factor-ĸB- and Glucocorticoid Receptor α- Mediated Mechanisms in the Regulation of Systemic and Pulmonary Inflammation during Sepsis and Acute Respiratory Distress Syndrome. Neuroimmunomodulation [online]. 2006; 12(6): 321–338 [cit. 2020-12-19]. Dostupné z: doi:10.1159/000091126

17. Jiang CL, Liu L, Tasker JG. Why do we need nongenomic glucocorticoid mechanisms? Frontiers in Neuroendocrinology [online]. 2014; 35(1): 72–75 [cit. 2020-12-19]. Dostupné z: doi: 10.1016/j.yfrne.2013.09.005

18. Buttgereit F, da Silva JA, Boers M, Cutolo M, Jacobs J, Kirwan J, et al. Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens: current questions and tentative answers in rheumatology. Ann Rheum Dis. 2002; 61: 718–722.

19. Meduri GU, Headley AS, Golden E, Carson SJ, Umberger RA, Kelso T, et al. Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA. 1998 Jul 8; 280(2): 159–165. doi: 10.1001/jama.280.2.159

20. Steinberg KP, Hudson LD, Goodman RB, Hough CL, Lanken PN, Hyzy R, et al. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med. 2006 Apr 20; 354(16): 1671–1684. doi: 10.1056/NEJMoa051693

21. Meduri GU, Golden E, Freire AX, Taylor E, Zaman M, Carson SJ, et al. Methylprednisolone infusion in early severe ARDS: results of a randomized controlled trial. Chest. 2007 Apr; 131(4): 954– 963. doi: 10.1378/ chest.06-2100.

22. Villar J, Ferrando C, Martínez D, Ambrós A, Munoz T, Soler JA, et al. Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial. Lancet Respir Med. 2020 Mar; 8(3): 267–276. doi: 10.1016/S2213-2600(19)30417- 5. Epub 2020 Feb 7.

23. WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Sterne JAC, Murthy S, Diaz JV, et al. Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta- analysis. JAMA. 2020 Oct 6; 324(13): 1330–1341. doi: 10.1001/jama.2020.17023. PMID: 32876694; PMCID: PMC7489434.

24. Angus DC, Derde L, Al-Beidh F, Annane D, Arabi Y, Beane A, et al. Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial. JAMA. 2020 Oct 6; 324(13): 1317–1329. doi: 10.1001/jama.2020.17022.PMID: 32876697 Clinical Trial.

25. Dequin PF, Heming N, Meziani F, Plantefève G, Voiriot G, Badié J, et al. Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19: A Randomized Clinical Trial. JAMA. 2020 Oct 6; 324(13): 1298–1306. doi: 10.1001/ jama.2020.16761.

26. Tomazini BM, Maia IS, Cavalcanti AB, Berwanger O, Rosa R, Veiga VC, et al. Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial. JAMA. 2020 Oct 6; 324(13): 1307–1316. doi: 10.1001/jama.2020.17021.

27. Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, et al. Dexamethasone in Hospitalized Patients with Covid-19. RECOVERY Collaborative Group, N Engl J Med. 2021 Feb 25; 384(8): 693–704. doi: 10.1056/NEJMoa2021436. Epub 2020 Jul 17. PMID: 32678530

28. Nicholson JN, Wooster L, Sigurslid HH, Li RH, Jiang W, Tian W, et al. Estimating risk of mechanical ventilation and in-hospital mortality among adult COVID-19 patients admitted to Mass General Brigham: The VICE and DICE scores. E Clinical Medicine. Mar 2021; 33: 100765. doi: 10.1016/j.eclinm.2021.100765

29. King CS, Sahjwani D, Brown AW, Feroz S, Cameron P, Osborn E, et al. Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure. PLoS ONE. 2020; 15(11): e0242651. https://doi.org/10.1371/journal. pone.0242651

30. Liu D, Ahmet A, Ward L, Krishnamoorty P, Mandelcorn ED, Leigh R, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. 2013 Aug 15; 9(1): 30. doi: 10.1186/1710-1492-9-30.

31. De Backer D, Azoulay E, Vincent JL. Corticosteroids in severe COVID-19: a critical view of the evidence. Crit Care. 2020 Oct 29; 24(1): 627. doi: 10.1186/s13054-020- 03360-0. PMID: 33121512; PMCID: PMC7595567.

32. Corticosteroids for COVID-19 [online]. Dostupné ke stažení na adrese: https://www.who.int/ publications/i/item/WHO-2019-nCoV-Corticosteroids-2020.1

33. Kümpel P, Holub M, Roháčová H, Plíšek S. Doporučený postup Společnosti infekčního lékařství ČLS JEP pro léčbu pacientů s onemocněním covid-19. Dostupné z: https://www. infekce.cz/Covid2019/DP-SIL-covid29p.pdf

34. Manson JJ, Crooks C, Naja M, Ledlie A, Goulden B, Liddle T, et al. COVID-19-associated hyperinflammation and escalation of patient care: a retrospective longitudinal cohort study. Lancet Rheumatol. 2020 Oct; 2(10): e594–e602. doi: 10.1016/S2665-9913(20)30275- 7. Epub 2020 Aug 21.

35. Munch MW, Granholm A, Myatra SN, Vijayaraghavan B, Cronhjort M, Wahlin RR, et al. Higher vs lower doses of dexamethasone in patients with COVID-19 and severe hypoxia (COVID STEROID 2) trial: Protocol and statistical analysis plan. Acta Anaesthesiol Scand. 2021; 00: 1–12.

36. Maláska J, Stašek J, Duška F, Balík M, Máca J, Hruda J, et al. Effect of dexamethasone in patients with ARDS and COVID-19 – prospective, multi-centre, open-label, parallel-group, randomised controlled trial (REMED trial): A structured summary of a study protocol for a randomised controlled trial. Trials (2021); 22: 172. https://doi.org/10.1186/s13063-021- 05116-9