Corticosteroid therapy involves the activated glucocorticoid receptor α

GC-GRα

Corticosteroids

The results from this study shows that there mght not be an effect of corticosteroid treatment or even a negative effect on in-hospital moratlity rates for severe and critical Covid-19 cases

Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China

SARS-CoV-2 negatively impacts the cortisol stress response. Corticosteroid therapy is efficient in treating severe COVID-19


Michigan State University

Cortisol is a steroid hormone that plays a role in metabolism and the immune response. (i.e. It is released when stress levels are increased or blood-glucose levels are low)

Cortisol

Arabi, Y. M., Chrousos, G. P., & Meduri, G. U. (2020). The ten reasons why corticosteroid therapy reduces mortality in severe COVID-19.

The ten reasons why corticosteroid therapy reduces mortality in severe COVID-19

- Those with COVID-19 showed a greater acute cortisol stress response compared to those who did not contract COVID-19.
- There is a positive association between cortisol levels and mortality
   - If cortisol levels increased, then the likelihood of death would increase
- Patients did not show adrenal insufficiency immediately, which is caused by low cortisol levels, but adrenal insufficiency will mostly increase a while after the onset of the virus
- In a study, it was found that when cortisol levels were greater than 744 nmol/L, there was a decrease in survival probability over a span of 42 days

Cortisol Concentrations and COVID-19 Mortality

- The HADS scale was used to determine levels of anxiety and depression
- It was found that there is a statistically significant relationship between the HADS score and cortisol levels
  - As levels of depression and anxiety increased, cortisol levels also increased
- COVID-19 Patients who had passed away had higher serum cortisol levels compared to the COVID-19 patients that survived
- Stress increases one’s susceptibility to respiratory tract infections, making patients more vulnerable to getting a cold
  - The immune cells become unable to regulate inflammation
- As tissues become less sensitive to cortisol due to high levels of stress, it becomes more difficult to regulate stress levels

Anxiety and Cortisol Levels in COVID-19 Patients

Corticosteroids and Treament of COVID-19

Diurnal cortisol secretions (AUCg) and the cortisol awakening response (CAR) play a role in determining how susceptible someone is to the SARS-CoV-2 virus.

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