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 Michel Tagliati;Marianna Leopoulou;Jo Ann LeQuang;Charles E. Wollmuth;Joseph V. Pergolizzi;Kailyn Mitchell;Peter Magnusson

作者机构：Proactive Health Inc. Stockholm Sweden Cardiology Clinic Athens General Hospital “Elpis” Athens Greece NEMA Research Inc. Naples Florida USA Centre for Research and Development Region Gavleborg/Uppsala University Gavle Sweden Department of Medicine Cardiology Research Unit Karolinska Institutet Stockholm Sweden 

出 版 物：《Pharmacology & Pharmacy》 (药理与制药（英文）)

年 卷 期：2021年第12卷第1期

页      面：10-24页

学科分类：1007[医学-药学(可授医学、理学学位)] 10[医学] 

主　　题：Ciclesonide Coronavirus COVID-19 Dexamethasone SARS-CoV-2 

摘      要：Introduction: 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 (but not other steroids) may confer mortality benefits on ventilated COVID-19 patients.Methods: 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.Results: 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. Furthermore, the virus is able to undergo RNA recombination rapidly, enabling it to evade host