ReviewInternational journal of molecular sciences2021
Dexamethasone for Severe COVID-19: How Does It Work at Cellular and Molecular Levels?
Review in International journal of molecular sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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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
23 citing papers in PubMed, 35 citations in OpenAlex.
- Development of a machine learning-based mortality prediction model for patients with mental disorders and COVID-19.Frontiers in cellular and infection microbiology · 2026Article
- Drug repurposing of sophoridine for sepsis-induced organ injury: from in-depth analysis of a single agent to a multi-target therapeutic paradigm.Frontiers in pharmacology · 2026Review
- Dexamethasone disrupts intracellular pH homeostasis to delay coronavirus infectious bronchitis virus cell entry via sodium hydrogen exchanger 3 activation.Journal of virology · 2025Article
- Improving dexamethasone drug loading and efficacy in treating rheumatoid arthritis via liposome: Focusing on inflammation and molecular mechanisms.Animal models and experimental medicine · 2025Review
- Sex-dependent improvement in traumatic brain injury outcomes after liposomal delivery of dexamethasone in mice.Bioengineering & translational medicine · 2024Article
- Genetic variability in the glucocorticoid pathway and treatment outcomes in hospitalized patients with COVID-19: a pilot study.Frontiers in pharmacology · 2024Article
- Navigating the Landscape of Hydrocortisone Administration in Septic Shock: Current Concepts and Future Directions.Cureus · 2023Review
- Relationship between glucocorticoids and viral load during the Omicron wave in mainland China.Virology journal · 2023Article
- Multi-Residue Detection of Eight Glucocorticoids by Nano-Au/Fluticasone Propionate Electrochemical Immunosensor.Molecules (Basel, Switzerland) · 2023Article
- Glucocorticoid Signaling Pathway: From Bench to Bedside.International journal of molecular sciences · 2023Article
- Drug Cocktail Formulation via Circuit Design.IEEE transactions on molecular, biological, and multi-scale communications · 2023Article
- Immuno-Modulatory Effects of Dexamethasone in Severe COVID-19-A Swedish Cohort Study.Biomedicines · 2023Article
- A Clinical Update on SARS-CoV-2: Pathology and Development of Potential Inhibitors.Current issues in molecular biology · 2023Review
- Dexamethasone impairs the expression of antimicrobial mediators in lipopolysaccharide-activated primary macrophages by inhibiting both expression and function of interferon β.Frontiers in immunology · 2023Article
- Immune and ionic mechanisms mediating the effect of dexamethasone in severe COVID-19.Frontiers in immunology · 2023Article
- Extract of Cimicifuga racemosa (L.) Nutt protects ovarian follicle reserve of mice against in vitro deleterious effects of dexamethasone.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2023Article
- Article
- New Insights on Effects of Glucocorticoids in Patients With SARS-CoV-2 Infection.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Review
- Preliminary study regarding the predicted body weight-based dexamethasone therapy in patients with COVID-19 pneumonia.Pulmonary pharmacology & therapeutics · 2022Article
- A Retrospective Study of Dexamethasone, Remdesivir, and Baricitinib in Severe COVID-19.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2022Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The coronavirus disease 2019 (COVID-19) caused by infection of the severe respiratory syndrome coronavirus-2 (SARS-CoV-2) significantly impacted human society. Recently, the synthetic pure glucocorticoid dexamethasone was identified as an effective compound for treatment of severe COVID-19. However, glucocorticoids are generally harmful for infectious diseases, such as bacterial sepsis and severe influenza pneumonia, which can develop respiratory failure and systemic inflammation similar to COVID-19. This apparent inconsistency suggests the presence of pathologic mechanism(s) unique to COVID-19 that renders this steroid effective. We review plausible mechanisms and advance the hypothesis that SARS-CoV-2 infection is accompanied by infected cell-specific glucocorticoid insensitivity as reported for some other viruses. This alteration in local glucocorticoid actions interferes with undesired glucocorticoid to facilitate viral replication but does not affect desired anti-inflammatory properties in non-infected organs/tissues. We postulate that the virus coincidentally causes glucocorticoid insensitivity in the process of modulating host cell activities for promoting its replication in infected cells. We explore this tenet focusing on SARS-CoV-2-encoding proteins and potential molecular mechanisms supporting this hypothetical glucocorticoid insensitivity unique to COVID-19 but not characteristic of other life-threatening viral diseases, probably due to a difference in specific virally-encoded molecules and host cell activities modulated by them.
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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.