[1/4] Anyone on #medtwitter or #covid4MDs started using steroids to treat #COVID19?
(At our institution we have moved away from the no-steroid dogma and anecdotally had good results in avoiding intubation with the use of high doses at the onset of worsening hypoxia or CRS)
(At our institution we have moved away from the no-steroid dogma and anecdotally had good results in avoiding intubation with the use of high doses at the onset of worsening hypoxia or CRS)
[2/4] Currently we've been using:
1. Methylprednisolone 125 mg daily
2. Decadron 10 mg IVP or PO BID
3. Prednisone 1 mg/kg PO in less severe cases
Which have you been using? If other, leave a comment below.
1. Methylprednisolone 125 mg daily
2. Decadron 10 mg IVP or PO BID
3. Prednisone 1 mg/kg PO in less severe cases
Which have you been using? If other, leave a comment below.
[3/4]
Criteria for initiation are debated. We have been using:
1. Significant hypoxia at admission or worsening hypoxia.
2. Lab evidence of severe disease (i.e. ferritin >1000 mg/dL, rising inflammatory markers, lymph count <20%, thrombocytopenia, etc)
3. Evolving CRS.
Criteria for initiation are debated. We have been using:
1. Significant hypoxia at admission or worsening hypoxia.
2. Lab evidence of severe disease (i.e. ferritin >1000 mg/dL, rising inflammatory markers, lymph count <20%, thrombocytopenia, etc)
3. Evolving CRS.
[4/4]
One theory at play is that high dose steroids have anti-histiocytic / macrophage properties, which appear to be the primary culprit of excess cytokine production.
Would love to know anyone's thoughts and experiences in this matter.
We are all in this together.
One theory at play is that high dose steroids have anti-histiocytic / macrophage properties, which appear to be the primary culprit of excess cytokine production.
Would love to know anyone's thoughts and experiences in this matter.
We are all in this together.
