关于新型冠状病毒肺炎患者中系统性糖皮质激素使用的几点想法

Comments on the systemic corticosteroid strategy for the coronavirus disease 2019(COVID-19)

新型冠状病毒肺炎(简称新冠肺炎)的国内外专家共识/指南一致认可系统性糖皮质激素在重症、危重症新冠肺炎患者中的疗效,地塞米松(6 mg,1次/d,疗程≤10 d)为推荐的糖皮质激素应用方案。但综合诸多关于新冠肺炎的临床试验以及临床实践看,新冠肺炎治疗中的糖皮质激素方案亟需个体化,建议结合患者的基础免疫状态和人口学特征、新冠肺炎的进展速度和严重程度、患者的炎症状态以及是否合并应用非糖皮质激素的抗炎药物等具体情况来制定个体化方案。

Systemic corticosteroid is considered effective in treating severe or critical coronavirus disease 2019(COVID-19)patients in both Chinese and international consensus and/or guidelines.Dexamethasone(6 mg daily for up to 10 days)is usually recommended.However,based on the outcomes of variable clinical trials and our clinical experience in treating the COVID-19 patients,the starting time,initial dosage and course of corticosteroid might be varied case by case.Individualized administration of corticosteroid is suggested according to the COVID-19 patient′s demographic characteristics,underlying disease and immune status,severity and progression rate of COVID-19,inflammatory condition and concomitant use of non-steroidal anti-inflammatory drugs.