COVID-19 Pharmacological Management
Corticosteroids

Corticosteroids

Recommendations

Chronic inhaled corticosteroids used daily for patients with asthma and chronic obstructive pulmonary disease for control of airway inflammation should not be discontinued in patients with COVID-19

  • Corticosteroids used prior to COVID-19 diagnosis for another underlying condition (e.g., primary or secondary adrenal insufficiency, rheumatological diseases) should not be discontinued.
  • On a case-by-case basis, supplemental or stress-dose steroids should be used.

Initiation of antepartum corticosteroids for fetal maturation could be considered as per current guidelines if preterm delivery is indicated or anticipated based on maternal condition (SOGC)

Insufficient data to recommend either for or against corticosteroid therapy in the absence of another indication (asthma, AECOPD, refractory shock)

  • For refractory shock, recommend using low-dose corticosteroid therapy (i.e., shock reversal) NIH guidelines
  • Consideration can be given for intubated patients with ARDS e.g.:
    • 10mg of dexamethasone daily or
    • 40-60mg/day of methylprednisolone
    • SSC/CMAJ guidelines