Steroids treatment has been studied in influenza, SARS, MERS, COVID-19
and ARDS, but no clear guidelines or recommendations are available
regarding the dose and the duration. In this review we summarize the
studies available on steroids and influenza, SARS, MERS, COVID-19 and
evaluated them according to the steroid dose, duration and beneficial
and harmful effects. Steroids were not much useful in influenza
infection, but have shown beneficial effects in SARS and COVID-19.
Intimidate and high doses for a short duration in SARS is beneficial,
especially if used after the viral replication phase. Methyl
prednisolone is the preferred steroid compared to hydrocortisone and can
be combined with intravenous immunoglobulin, ribavirin, quinolone plus
azithromycin. Limited studies are available for COVID-19 and steroids to
provide recommendations and steroids use can be harmful in critically
ill patients. Delayed viral clearance, secondary bacterial infections,
cardiovascular events due to fluid retention, psychosis, diabetes,
avascular necrosis and osteoporosis can be side effects of steroid use.