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Recent Developments in Therapies and Strategies Against COVID-19
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Misbah Hameed, M. Zia-Ul-Haq, Marius Moga
The doses of methylprednisolone used in different trials for COVID-19 patients is 1–2 mg/kg daily IV for 5–7 days. Chinese Thoracic Society recommends that the dose of methylprednisolone should be ≤ 0.5 to 1 mg/kg daily [52].
Medicines in neonates
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Three glucocorticoids capable of crossing the placental barrier to the fetus have been used in randomised trials: betamethasone, dexamethasone and hydro-cortiosone. Some trials used methylprednisolone, but this steroid does not cross the placenta. The evidence from the small trials in which it was used do not support the use of hydrocortisone to reduce the risks of RDS [7].
Diagnosis and Treatment of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
For patients with progressive deterioration of oxygenation indicators, rapid imaging progress, and excessive activation of inflammatory response, the use of glucocorticoids in the short term (3–5 days) should be considered. The dosage of methylprednisolone should not exceed 1–2 mg/kg/day. It should be noted that large doses of glucocorticoids will delay the removal of coronavirus due to immunosuppressive effects. Intestinal microecological regulators can be used to maintain intestinal microecological balance and prevent secondary bacterial infections. For severe and critically severe children, intravenous gamma globulin should be considered.
Bilateral orbital inflammation in a 6-month old with SARS-CoV-2 infection
Published in Orbit, 2022
Christopher R. Dermarkarian, Madhuri Chilakapati, Mohamed Hussein, Patricia Chévez-Barrios, Richard C. Allen
Laboratory testing demonstrated leukocytosis (20.26×10*3/uL), thrombocytosis (583×10*3/uL), elevated CRP (2.9 mg/dL), elevated sedimentation rate (86 mm/hr), and elevated D-dimer (1.48 ug/mL). Respiratory viral panel PCR was positive for SARS-CoV-2 virus and human metapneumovirus. Antibody testing for SARS-CoV-2 IgM, partial IgA and IgG was positive. Blood cultures, peripheral blood smear, IgG subclasses, including IgG4 (0.6 mg/dL), angiotensin-converting enzyme (15 u/L), and Epstein-Barr virus PCR (<261 IU/mL) were normal. CT demonstrated soft tissue changes and enlargement of both lacrimal glands (Figure 1A). MRI demonstrated bilateral enhancement of the lacrimal glands and extraconal spaces (Figure 1B). The patient received intravenous ceftriaxone, vancomycin, and metronidazole with minimal improvement. After initiation of intravenous methylprednisolone at 1 mg/kg every 12 hours for 2 days, the patient’s condition significantly improved. The patient was discharged on an oral prednisone taper.
Advances in the Pharmacological Management of Pediatric Acute Respiratory Distress Syndrome
Published in Expert Opinion on Pharmacotherapy, 2022
Maria Gabriella Matera, Francesco Imperatore, Rosa Annibale, Mario Cazzola
The RECOVERY study demonstrated that corticosteroids do not improve outcomes and may cause harm in adult patients with mild to moderate COVID-19 who are not receiving supplemental oxygen [75]. Nevertheless, the use of dexamethasone lead to a lower 28-day incidence of mortality than those who had solely received either invasive mechanical ventilation or oxygen at randomization. Still, the safety and efficacy of dexamethasone or other corticosteroids for the treatment of COVID-19 have not been sufficiently evaluated in children. However, translating what has been observed in adults to children, dexamethasone may be useful in children requiring mechanical ventilation while its use for those requiring supplemental oxygen support should be considered on a case-by-case basis [69]. Indeed, the COVID-19 Treatment Guidelines recommend using corticosteroids for hospitalized children with COVID-19 who require high-flow oxygen, noninvasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation [74]. In these cases, the recommendation is to use methylprednisolone at a dose of 1–2 mg/kg/day for a maximum of 4–5 days [76].
Thyroid-Associated Orbitopathy: Management and Treatment
Published in Journal of Binocular Vision and Ocular Motility, 2022
Lauren Hennein, Shira L. Robbins
Intravenous (IV) corticosteroids may be more effective and better tolerated than oral corticosteroids.45 Further, IV corticosteroids can be used in the short term as urgent treatment to decelerate activity in patients with sight-threatening disease.32 Intravenous methylprednisolone is associated with improved ocular motility and CAS, but has not been shown to be associated with improvement in exophthalmos, palpebral aperture, soft tissue changes, and subjective diplopia.44 Further, optic neuropathy may not be prevented with the use of intravenous methylprednisolone and patients may experience a relapsing orbitopathy after steroid withdrawal.44 Minor adverse events associated with the use of intravenous methylprednisolone include skin flushes during infusion, mild cushingoid features (i.e. bruising, skin striae, dorsal cervical fat pad), increase in blood pressure, acid reflux, and weight gain.44 Major adverse events associated with the use of intravenous methylprednisolone include profound muscle weakness, major depression, psychosis, diabetes mellitus requiring therapy, myocardial infarction and infection requiring hospitalization.44