Previous Steroid Use and Severity of COVID-19

Corticosteroid use is associated with infection and other adverse events because of its immunosuppressive properties. Severe infections run a triphasic course. In the first phase, respiratory symptoms and fever result from an innate and adaptive immune system response to eliminate the virus. In the second phase, viral multiplication and lung inflammation result from pneumonia. The third phase is a syndrome of hyperinflammation due to high levels of pro-inflammatory cytokines such as interleukin IL-2, IL-6, IL-7, and tumor necrosis factor-alpha.