Glucocorticoids are Harmful in Treating Viral Respiratory Infections: Study

Glucocorticoids use in the treatment of viral respiratory infections is harmful. The study is extremely important, especially during the current pandemic, as the COVID-19 disease hinders the body's interferon-alpha and beta (IFNs) production. The findings of the study are published in the journal Intensive Care Medicine.

The main reason seems to be that there is no effective treatment for ARDS patients on ventilators. The death rate of these patients differs between 30-40 percent depending on the data.

Acute Respiratory Distress Syndrome - Causes Diagnosis Treatment Complications FAQ
ARDS is a lung condition where the patient suffers from sudden breathlessness, low blood oxygen levels and lung inflammation that could progress to respiratory failure.

‘WHO has forbidden the use of glucocorticoids in treating COVID-19. ’

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ARDS is often caused by serious viral or bacterial infection. Type I interferons alpha and beta (IFNs) are signaling proteins produced by the human body and are needed to fight off viral infections. For this reason, IFNs have been used successfully in treating ARDS in early-phase clinical trials. However, in a recently published later-phase clinical trial (INTEREST), this effect was no longer observed. The trial was carried out as an international study covering 300 patients at different medical centers.

A closer analysis revealed that most patients who participated in the study had received glucocorticoids in addition to IFN beta, which proved to be exceedingly harmful. The death rate of patients who were treated only with interferons was 10.6 percent, but the addition of glucocorticoids increased the death rate to 39.7 percent.

Glucocorticoids inhibit interferon signaling and increase mortality

What is the Best Treatment for Acute Respiratory Distress Syndrome?
The best treatment for Acute Respiratory Distress Syndrome (ARDS) may be lower pressure volumes of ventilation called ultra-protective mechanical ventilation, as it creates less risk for typical lung injuries such as hyperinflation and barotrauma.

At the MediCity Research Laboratory of the University of Turku, Finland, the research groups of Academician, Professor Sirpa Jalkanen and Academy Research Fellow Maija Hollmén investigated what caused this abrupt increase in death rates.

The researchers demonstrated with cell and tissue cultures that glucocorticoids inhibit IFN signaling and prevent both the body's own and administered interferon from fighting against the disease.

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"This is probably the most important observation for saving human lives that I have made in my career. After we overcame the immense disappointment caused by the results of the INTEREST trial, we became sure that there had to be an explanation - and now we have found it", says Professor Sirpa Jalkanen.

The findings are extremely important, especially during the current pandemic, as the COVID-19 disease incapacitates the body's IFN production. WHO has already forbidden the use of glucocorticoids in treating COVID-19.

Complete Recovery After of Acute Respiratory Distress Syndrome (ARDS) May be Rare
Survivors of acute respiratory distress syndrome (ARDS) remain physically and emotionally weak five years after recovering

Source-Eurekalert