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All Journal International Journal of Biomedical Science and Travel Medicine
Ni Ketut Ayu Pramesti Ari
Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa, Denpasar, Bali
Medicine & Pharmacology Public Health

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Role of Corticosteroid in The Management of Covid-19 I Putu Bhujangga Pratama Kusuma Artana; I Gusti Agung Istri Mahaiswari; Gusti Agung Ksatrya; Ni Ketut Ayu Pramesti Ari; Saraswati Laksmi Dewi; Putu Aryagiri Prabawa
International Journal of Biomedical Science and Travel Medicine Vol. 3 No. 2 (2026)
Publisher : Publication Department, Universitas Warmadewa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/ijbstm.3.2.2026.48-53

Abstract

Systemic corticosteroids are an important immunomodulatory therapy for severe and critical coronavirus disease 2019 (COVID-19). Their anti-inflammatory effects may reduce excessive immune activation and pulmonary injury, although immunosuppression may impair antiviral responses and delay viral clearance. This review summarizes the role of corticosteroids in the management of COVID-19, focusing on mechanisms, clinical efficacy, indications, dosing, safety, and their use with other immunomodulatory therapies. Evidence from randomized controlled trials and meta-analyses demonstrates that corticosteroids, particularly dexamethasone, reduce mortality in patients requiring supplemental oxygen or advanced respiratory support, whereas routine use in patients without oxygen requirements is not recommended. Dexamethasone 6 mg once daily for up to 10 days or until discharge remains the best-established regimen. Higher doses do not necessarily provide additional benefit and may increase mortality and adverse events. Dexamethasone has the strongest direct evidence, while hydrocortisone and methylprednisolone have also demonstrated potential benefits, although comparative evidence remains heterogeneous. Corticosteroids may be combined with additional immunomodulatory agents, such as tocilizumab or baricitinib, in patients with persistent inflammation and clinical deterioration despite corticosteroid therapy. Overall, corticosteroid therapy should be individualized according to disease severity, oxygen requirement, dose, and treatment duration to balance suppression of pathological inflammation against preservation of antiviral immunity.
Co-Authors Gusti Agung Ksatrya I Gusti Agung Istri Mahaiswari I Putu Bhujangga Pratama Kusuma Artana Putu Aryagiri Prabawa Saraswati Laksmi Dewi