In December 2019, an outbreak of novel coronavirus threatened the health of mankind. There is no clinically proven vaccine apart from few antivirals treatments claiming efficacy. Although, corticosteroids have been widely used during outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome, there was significant controversy regarding their efficacy in treating coronavirus – 19. In infected Coronavirus disease- 2019 (COVID-19) patients, there is massive cytokine release called as ‘cytokine storm’ hyper inflammation and immune suppression with reduce helper CD4 cell response. Corticosteroids have a good inhibitory effect on inflammatory mediators and are often used as an additional treatment choice for viral pneumonia. The use of corticosteroids has been largely discouraged because of their immunosuppression effect & fear of worsening of viral propagation. Interest in corticosteroid therapy in COVID-19 has been studied after the results from Randomized Evaluation of COVID-19 therapy (RECOVERY) Trial. However, the World Health Organization has not recommended corticosteroid in the treatment of COVID-19. Many controversies have emerged about the use of corticosteroid in COVID 19.This review summarises the pathophysiology, role of corticosteroid in management, controversies about use of corticosteroid in COVID 19 disease. Various studies & literature review suggests that patients with severe conditions were more likely to require corticosteroids in treatment protocol. Corticosteroids should be used with caution in the treatment of COVID-19 patients & more multicentre clinical trials are further needed to support their use in management of covid-19.

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Shweta Thadeshwar

DY Patil School of Medicine, Navi Mumbai