Reduced lymphocytes counts and increased neutrophils to lymphocytes ration (NLR) is a prominent feature of COVID-19. Higher NLRs are associated with poor outcomes.
Glucocorticosteroids are elevated during stress and critical illness (read more in another article on this website). Elevated blood levels of endogenous corticosteroids and corticosteroids administered exogenously both change absolute numbers of different fractions of circulating leukocytes. Neutrophils go up. Lymphocytes go down. Administration of exogenous corticosteroids to COVID-19 patients should, therefore, further increase neutrophils to leukocytes ratio (NLR). If higher NLR is associated with poor outcomes in COVID-19, administration of corticosteroids would seem counterproductive. Are steroids used appropriately in the treatment of COVID-19?
In this article, we shares several graphic notes that we took during our reading on the topic of corticosteroid use in COVID-19 and SARS (2003-2004). The notes below are from a 1982 study by Cupps and Fauci (1).
Selected references:
1. Cupps, Fauci. Immunological Rev. (1982), Vol.65.
3 Comments