STEROID PADA COVID-19

Fariz Nurwidya, Itsna Arifatuz Zulfiyah

Abstract


Pada pasien Corona virus infection disease (COVID)-19 dengan gejala berat ditemukan kadar sitokin proinflamasi yang tinggi dibandingkan dengan pasien bergejala ringan hingga sedang. Agen imunomodulator utama yang telah diketahui memiliki berbagai manfaat sekaligus efek samping adalah kortikosteroid. Tujuan artikel tinjauan pustaka ini adalah untuk mengelaborasi penggunaan kortikosteroid pada pasien COVID-19. Metode penulisan ini adalah deskripsi naratif berdasarkan panduan Organisasi Kesehatan Dunia, Perhimpunan Dokter Paru Indonesia dan berbagai penelitian uji klinis pada pasien COVID-19. Hasil penelusuran bukti ilmiah menunjukkan bahwa kortikosteroid telah diindikasikan untuk berbagai macam penyakit, yang secara umum dapat dibagi menjadi penyakit infeksi dan inflamasi, penyakit alergi dan autoimun. Kortikosteroid bekerja dengan mekanisme yang kompleks, yang terdiri dari mekanisme genomik dan nongenomik. Pada COVID-19, kortikosteroid digunakan secara sistemik dan dapat diberikan melalui rute oral atau injeksi. Berdasarkan berbagai bukti ilmiah dari uji pra-klinis dan uji klinis yang meneliti aspek indikasi, mekanisme kerja, efek samping, interaksi obat, dan penggunaan pada kelompok khusus, disimpulkan bahwa steroid efektif dan aman digunakan pada pasien COVID-19 membutuhkan suplementasi oksigen pada perawatan di rumah sakit.

Keywords


steroid; inflamasi; COVID-19; indikasi

Full Text:

PDF

References


Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017;39(5):529–39.

Azkur AK, Akdis M, Azkur D, Sokolowska M, Veen W, Brüggen M, et al. Immune response to SARS‐CoV‐2 and mechanisms of immunopathological changes in COVID‐19. Allergy. 2020;75(7):1564–81.

Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020;20(6):363–74.

Choudhary S, Sharma K, Silakari O. The interplay between inflammatory pathways and COVID-19: A critical review on pathogenesis and therapeutic options. Microb Pathog. 2021;150:104673.

Kim JS, Lee JY, Yang JW, Lee KH, Effenberger M, Szpirt W, et al. Immunopathogenesis and treatment of cytokine storm in COVID-19. Theranostics. 2021;11(1):316–29.

Cano EJ, Fonseca Fuentes X, Corsini Campioli C, O’Horo JC, Abu Saleh O, Odeyemi Y, et al. Impact of Corticosteroids in Coronavirus Disease 2019 Outcomes. Chest. 2021;159(3):1019–40.

Quirch M, Lee J, Rehman S. Hazards of the Cytokine Storm and Cytokine-Targeted Therapy in Patients With COVID-19: Review. J Med Internet Res. 2020;22(8):e20193.

Hodgens A, Sharman T. Corticosteroids. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [diunduh 17 Maret 2021]. Tersedia dari: https://www.ncbi.nlm.nih.gov/books/NBK554612/

Williams DM. Clinical Pharmacology of Corticosteroids. Respir Care. 2018;63(6):655–70.

Arabi YM, Mandourah Y, Al-Hameed F, Sindi AA, Almekhlafi GA, Hussein MA, et al. Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome. Am J Respir Crit Care Med. 2018;197(6):757–67.

Stockman LJ, Bellamy R, Garner P. SARS: Systematic Review of Treatment Effects. Low D, editor. PLoS Med. 2006;3(9):e343.

Rodrigo C, Leonardi-Bee J, Nguyen-Van-Tam J, Lim WS. Corticosteroids as adjunctive therapy in the treatment of influenza. Cochrane Acute Respiratory Infections Group, editor. Cochrane Database Syst Rev [Internet]. 2016 Mar 7 [diunduh 20 Maret 2021]. Tersedia dari: http://doi.wiley.com/10.1002/14651858.CD010406.pub2

COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines [Internet]. National Institutes of Health; 2021 [diunduh 17 Maret 2021]. Tersedia dari: https://www.covid19treatmentguidelines.nih.gov/

World Health Organization. Corticosteroids for COVID-19: Living guidance [Internet]. WHO; 2020 [diunduh 17 Maret 2021]. Tersedia dari: https://www.who.int/publications-detail-redirect/WHO- 2019-nCoV-Corticosteroids-2020

Mourad A, Thibault D, Holland TL, et al. Dexamethasone for Inpatients With COVID-19 in a National Cohort. JAMA Netw Open. 2023;6(4):e238516.

Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, et al. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021;384(8):693–704.

Tomazini BM, Maia IS, Cavalcanti AB, Berwanger O, Rosa RG, Veiga VC, et al. COALITION COVID-19 Brazil III Investigators. Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial. JAMA. 2020;324(13):1307-1316.

Shuto H, Komiya K, Yamasue M, Uchida S, Ogura T, Mukae H, et al. A systematic review of corticosteroid treatment for noncritically ill patients with COVID-19. Sci Rep. 2020;10(1):20935.

Burhan E, Susanto AD, Isbaniah F, Nasution SA, Ginanjar E, Pitoyo CW, et al. Pedoman Tatalaksana COVID-19. 3rd ed. Jakarta: Perhimpunan Dokter Paru Indonesia; 2020.

Waljee AK, Rogers MA, Lin P, Singal AG, Stein JD, Marks RM, Ayanian JZ, Nallamothu BK. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ. 2017;357:j1415.




DOI: https://doi.org/10.36409/jika.v8i2.144

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.