Tailored modulation of the inflammatory balance in COVID-19 patients admitted to the ICU?-a viewpoint

Crit Care. 2021 May 25;25(1):178. doi: 10.1186/s13054-021-03607-4.

Abstract

A growing consensus seems to be emerging that dexamethasone is a crucial component in the treatment of COVID-19-associated oxygen-dependent respiratory failure. Although dexamethasone has an undeniably beneficial effect on the inflammatory response in a subgroup of patients, the potential negative effects of corticosteroids must also be considered. In view of these negative effects, we argue that a one-size-fits-all dexamethasone approach may be potentially harmful in specific subsets of patients with COVID-19-associated ARDS. We propose a different individually tailored treatment strategy based on the patient's inflammatory response.

Keywords: COVID-19; Coronavirus; Dexamethasone; Inflammation.

MeSH terms

  • COVID-19 / complications
  • COVID-19 Drug Treatment*
  • Critical Care / methods*
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use*
  • Humans
  • Inflammation / prevention & control*
  • Intensive Care Units
  • Respiratory Insufficiency / drug therapy*
  • Respiratory Insufficiency / virology
  • Treatment Outcome

Substances

  • Dexamethasone