Steroids and Long COVID

Many patients ask me about steroids early in the treatment of long COVID-19. While it’s true that steroids are often used in hospitalized patients with active COVID-19, the evidence for their effectiveness in patients who are recovering is not strong.

In fact, in animal studies of how COVID affects the brain, it appears that the non-judicious use of steroids in COVID-19 infection can make things worse.  That’s because early in COVID-19 infection, the immune system needs to be fully functional and at full speed.  Steroids like prednisone and dexamethasone shut down immune defense systems, which gives the virus an unchecked advantage in spreading inside the body.

When COVID-19 patients land in the hospital, its usually because their lungs are failing.  The current evidence indicates that in some people, due to underlying disease or genetic factors, COVID-19 infection triggers a hyper-reaction in their immune system.  The lungs are at ground zero of this reaction and are damaged in the cross-fire.  In this setting, steroids are used to tone-down the immune response to lessen lung damage.

How Would Steroids Help in Long COVID?

We are at the very edge of understanding this question. The first studies that will answer this will be conducted in hamsters, a species that remarkably mimics COVID-19 infection in humans.

It will be sometime before we know how applicable these findings are to humans. Nonetheless, these studies are encouraging and provide additional insight into COVID-19 and long Covid symptoms.

Long COVID is a fascinating medical challenge!  Helping patients navigate to recovery from Long COVID is a top priority at Wellivery.  Keep track of Long COVID developments by bookmarking the Wellivery Long COVID page.