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Steroid Stewardship in COVID-19.
Gentle Sunder Shrestha1, Ankit Rimal1
1Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
Corticosteroids are a proven COVID-19 treatment, but their use varies. A steroid stewardship program can optimize benefits and minimize adverse effects from this vital therapy.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Corticosteroids significantly impact COVID-19 clinical practice, evidenced by the RECOVERY trial.
- Discrepancies exist in physician prescribing habits regarding corticosteroid dosage and duration for COVID-19.
- The therapeutic benefits of corticosteroids in COVID-19 are often accompanied by significant adverse effects.
Purpose of the Study:
- To highlight the importance of optimizing corticosteroid therapy in COVID-19.
- To advocate for the implementation of institutional steroid stewardship programs.
- To address the variability in corticosteroid prescribing and mitigate associated risks.
Main Methods:
- Review of clinical trial data, specifically the RECOVERY trial findings.
- Analysis of current prescribing practices and physician-reported disparities.
- Conceptual framework for an institutional steroid stewardship program.
Main Results:
- Corticosteroids represent a key therapeutic intervention for COVID-19.
- Variability in steroid dosing and duration poses a clinical challenge.
- Steroid stewardship programs offer a strategy to balance efficacy and safety.
Conclusions:
- Institutional steroid stewardship programs are essential for maximizing the benefits of corticosteroids in COVID-19.
- These programs can help standardize care, reduce overuse, and minimize adverse events.
- Implementing stewardship promotes evidence-based use of this critical treatment.
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