ReviewJournal of endocrinological investigation2021
What we have to know about corticosteroids use during Sars-Cov-2 infection.
Review in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Who and how to screen for Cushing's syndrome: the position statement of the Italian Society of Endocrinology.Journal of endocrinological investigation · 2026Guideline
- Health-related quality of life and patterns of psychological vulnerability in autoimmune Addison's disease: a systematic review.Frontiers in endocrinology · 2026Pooled it
- Anxiety disorders: a cross-sectional study of clinical and biological associations.Journal of neural transmission (Vienna, Austria : 1996) · 2026Article
- MEK1/2 inhibitor ATR-002 reshapes host transcriptome and modulates immune regulatory genes in SARS-CoV-2 infection.Frontiers in immunology · 2026Article
- A High-Calorie Diet Aggravates Lipopolysaccharide-Induced Pulmonary Inflammation in Juvenile Rats via Hypothalamic-Pituitary-Adrenal Axis-Related Pathways.International journal of molecular sciences · 2025Article
- Design and Characterization of Bispecific and Trispecific Antibodies Targeting SARS-CoV-2.Vaccines · 2025Article
- Omega-3 Polyunsaturated Fatty Acids in Chronic Obstructive Pulmonary Disease Patients with COVID-19: A Review.Current nutrition reports · 2025Review
- A schedule for tapering glucocorticoid treatment in patients with severe SARS-CoV 2 infection can prevent acute adrenal insufficiency in the geriatric population.Hormones (Athens, Greece) · 2024Article
- Taming the storm: potential anti-inflammatory compounds targeting SARS-CoV-2 MPro.Inflammopharmacology · 2024Review
- COVID-19 pandemic and adrenals: deep insights and implications in patients with glucocorticoid disorders.Endocrine · 2023Review
- Review
- The Relationship between COVID-19 and Hypothalamic-Pituitary-Adrenal Axis: A Large Spectrum from Glucocorticoid Insufficiency to Excess-The CAPISCO International Expert Panel.International journal of molecular sciences · 2022Review
- Inhalation of nebulized omega-3 fatty acids mitigate LPS-induced acute lung inflammation in rats: Implications for treatment of COPD and COVID-19.Prostaglandins, leukotrienes, and essential fatty acids · 2022Article
- Covid-19, the thyroid and the pituitary - The real state of play.Annales d'endocrinologie · 2022Article
- Cardiovascular implications of the COVID-19: Management of complications and drug safety concerns.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2022Review
- Immune response and potential therapeutic strategies for the SARS-CoV-2 associated with the COVID-19 pandemic.International journal of biological sciences · 2022Review
- A case of adrenal insufficiency during multisystem inflammatory syndrome in children.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2022Article
- Tele-medicine versus face-to-face consultation in Endocrine Outpatients Clinic during COVID-19 outbreak: a single-center experience during the lockdown period.Journal of endocrinological investigation · 2021Article
- Rethinking the management of immune checkpoint inhibitor-related adrenal insufficiency in cancer patients during the COVID-19 pandemic.Endocrinology, diabetes & metabolism · 2021Review
- Management of hyponatraemia and hypernatraemia during the Covid-19 pandemic: a consensus statement of the Spanish Society for Endocrinology (Acqua Neuroendocrinology Group).Reviews in endocrine & metabolic disorders · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGlucocorticoids (GCs), alone or associated to other drugs, were widely used in the management of patients affected by severe acute respiratory syndrome caused by SARS-CoV-2 infection, during the recent COVID-19 outbreak. This review summarizes the available data on HPA axis impairment in GC-treated SARS-CoV-2 patients, focusing on the risk of adrenal insufficiency and on potential drug interactions during concomitant treatments.
methodsLiterature on the impact of GCs therapy on HPA axis and on the consequences of coadministration of GCs and other drugs in SARS-CoV-2 patients has been reviewed.
resultsGC treatment can cause symptoms of hypercortisolism, especially in patients with individual hypersensibility, or hypoadrenalism after drug withdrawal, due to hypothalamic-pituitary-adrenal (HPA) axis suppression, with consequences in terms of increased morbidity and mortality risk. On the other hand, in SARS-CoV-2-infected patient's cortisol secretion could be insufficient also due to critical illness-related corticosteroid insufficiency (CIRCI). In addition, in this clinical context, the co-administration of antiretroviral drugs and corticosteroids may trigger drug-drug interaction and enhance the exposure to the latter ones, metabolized through the CYP450 CYP3A pathway, severely impacting on HPA axis.
conclusionPhysicians involved in the management of patients affected by COVID-19 should be aware of the need of an appropriate GC dose tapering, and of potential interaction of GCs with antiviral therapy and drugs used to treat associated co-morbidities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.