Thalidomide combined with low‐dose short‐term glucocorticoid in the treatment of critical Coronavirus Disease 2019

• Published in: Clinical and Translational Medicine 2020-06, Vol.10 (2), p.e35-n/a
• Main Authors: Chen, Chengshui, Qi, Feng, Shi, Keqing, Li, Yuping, Li, Ji, Chen, Yongping, Pan, Jingye, Zhou, Tieli, Lin, Xiangyang, Zhang, Jinsan, Luo, Yongde, Li, Xiaokun, Xia, Jinglin
• Format: Article
• Language: English
• Subjects: Short Communication
• ISSN: 2001-1326; 2001-1326
• DOI: 10.1002/ctm2.35

Abbreviations ARDS acute respiratory distress syndrome IFN interferon IL interleukin MERS Middle East respiratory syndrome rRT‐PCR real‐time reverse‐transcriptase polymerase chain reaction COVID‐19 coronavirus disease 2019 SARS‐CoV‐2 severe acute respiratory syndrome coronavirus 2 An epidemic illness caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), now named Coronavirus Disease 2019 (COVID‐19), occurred in Wuhan, China.1 The human‐to‐human contagious transmission of SARS‐CoV‐2 has been confirmed, leading to rapid spreading to tens of thousands of patients in China and other regions in the world.2-5 Organ dysfunction, including acute respiratory distress syndrome (ARDS), shock, and death may occur.6 Therefore, many COVID‐19 patients also suffered from anxiety, especially under treatment in intensive care units. Chest computerized tomography indicated signs of the subpleural effusions in the left upper and left lower lung (Figures 1A and 1B). [...]the patient was diagnosed with COVID‐19, and treated with lopinavir/ritonavir. According to Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the sixth edition), the patient was classified into the critical phenotype. High dose of Glucocorticoid is usually used for suppressing cytokine surge, which therefore was widely applied during the outbreaks of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) CoV infections to suppress lung inflammation and immune responses.16 However, it appeared to be associated with treatment side effects, such as secondary bacterial infection, osteoporosis, and others. [...]glucocorticoid was not recommended for critical COVID‐19 as used in SARS‐CoV or MERS‐CoV infections,17 also due to its inhibition of immune responses and pathogen clearance.