CORTICOSTEROIDS AND SECONDARY INFECTIONS: AN INSIGHT INTO CORONAVIRUS DISEASE-2019 (COVID-19)
Coronavirus disease 2019 (COVID-19), which is caused by novel coronavirus SARS-CoV-2, emerged at Wuhan in China in December 2019 and has rapidly spread throughout the world. The droplets expelled during face-to-face exposure mainly through talking, coughing, or sneezing is the most common mode of transmission. So far, children have not been affected frequently without deaths. But the course of this virus in future is unknown. The diagnosis is mainly made through Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and serology testing. Treatment with dexamethasone at an early phase of developed Acute Respiratory Distress Syndrome ( ARDS) caused by SARS-CoV-2 alters the pulmonary and systemic inflammatory response and decreases mortality. Corticosteroid therapy is associated with a sizable reduction in duration of mechanical ventilation and hospital mortality. One of the major risk factor associated with corticosteroid therapy is associated with acquiring secondary infections. Pulmonary epithelial damage and inflammatory disease are the predisposing risk factors for pulmonary aspergillosis due to release of danger molecular patterns during severe COVID-19. Bronchoalveolar lavage fluid galactomannan testing and culture, which are the most sensitive diagnostic tests for aspergillosis in Intensive Care Unit (ICU). Lastly, the treatment of Coronavirus Associated Pulmonary Aspergillosis (CAPA) is complex. The only way one can prevent the spread of infection by following precautions such as frequent hand washing, wearing a mask in public places, social distancing, and by avoiding unnecessary gatherings.
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