Ciclesonide Use in COVID-19: Not All Steroids Are the Same

• 作者: Michel Tagliati Marianna Leopoulou Jo Ann LeQuang Charles E. Wollmuth Joseph V. Pergolizzi Kailyn Mitchell Peter Magnusson
• 来源期刊: 药理与制药(英文)
• 学科: 医学
• 关键词: CICLESONIDE CORONAVIRUS COVID-19 DEXAMETHASONE SARS-CoV-2
• 年，卷（期）: 2021,（1）
• 页码范围: 10-24
• 页数: 15页
• 分类号: R97

摘要

<span style="font-family:Verdana;"><strong>Introduction:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The inflammatory mechanisms of COVID-19 suggest that corticosteroids may be beneficial, but their benefits must outweigh their potential risks. The RECOVERY trial results suggest that dexamethasone 6 mg/day </span><span style="font-family:Verdana;">(but not other steroids) may confer mortality benefits on ventilated COVID-19 </span><span style="font-family:Verdana;">patients.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This is a narrative review of the literature about the use of ciclesonide and dexamethasone for COVID-19 patients. Literature is being created rapidly and this review is offered as a state-of-the-science narration.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The SARS-CoV-2 virus is an RNA virus whose RNA is transcribed via open reading frames, making its elimination difficult. Coronaviruses have evolved multiple strategies for proteolytic activation of the spike;viral replication occurs entirely in the cytoplasm. In this connection, the RNA-cleaving endoribonuclease (NSP-15 also known as EndoU) may play a key role by facilitating viral double-stranded RNA recognition by the host’s macrophages. </span><span style="font-family:Verdana;">Furthermore, the virus is able to undergo RNA recombination rapidly,</span><span style="font-family:Verdana;"> enabling it to evade host immunity and develop drug resistance. Cicleson