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Review

Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis

1
Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
2
Public Health Research Institute at New Jersey Medical School, Rutgers University, 225 Warren Street, Newark, NJ 08854, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Anastasios Lymperopoulos
Int. J. Mol. Sci. 2021, 22(7), 3773; https://doi.org/10.3390/ijms22073773
Received: 12 March 2021 / Revised: 1 April 2021 / Accepted: 2 April 2021 / Published: 6 April 2021
(This article belongs to the Collection Feature Papers in Molecular Pharmacology)
On 11 March 2020, the World Health Organization announced the Corona Virus Disease-2019 (COVID-19) as a global pandemic, which originated in China. At the host level, COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), affects the respiratory system, with the clinical symptoms ranging from mild to severe or critical illness that often requires hospitalization and oxygen support. There is no specific therapy for COVID-19, as is the case for any common viral disease except drugs to reduce the viral load and alleviate the inflammatory symptoms. Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (Mtb), also primarily affects the lungs and has clinical signs similar to pulmonary SARS-CoV-2 infection. Active TB is a leading killer among infectious diseases and adds to the burden of the COVID-19 pandemic worldwide. In immunocompetent individuals, primary Mtb infection can also lead to a non-progressive, asymptomatic latency. However, latent Mtb infection (LTBI) can reactivate symptomatic TB disease upon host immune-suppressing conditions. Importantly, the diagnosis and treatment of TB are hampered and admixed with COVID-19 control measures. The US-Center for Disease Control (US-CDC) recommends using antiviral drugs, Remdesivir or corticosteroid (CST), such as dexamethasone either alone or in-combination with specific recommendations for COVID-19 patients requiring hospitalization or oxygen support. However, CSTs can cause immunosuppression, besides their anti-inflammatory properties. The altered host immunity during COVID-19, combined with CST therapy, poses a significant risk for new secondary infections and/or reactivation of existing quiescent infections, such as LTBI. This review highlights CST therapy recommendations for COVID-19, various types and mechanisms of action of CSTs, the deadly combination of two respiratory infectious diseases COVID-19 and TB. It also discusses the importance of screening for LTBI to prevent TB reactivation during corticosteroid therapy for COVID-19. View Full-Text
Keywords: SARS-CoV-2; coinfection; immunosuppression; latency; Mycobacterium tuberculosis; reactivation; antibodies; inflammation SARS-CoV-2; coinfection; immunosuppression; latency; Mycobacterium tuberculosis; reactivation; antibodies; inflammation
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MDPI and ACS Style

Gopalaswamy, R.; Subbian, S. Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis. Int. J. Mol. Sci. 2021, 22, 3773. https://doi.org/10.3390/ijms22073773

AMA Style

Gopalaswamy R, Subbian S. Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis. International Journal of Molecular Sciences. 2021; 22(7):3773. https://doi.org/10.3390/ijms22073773

Chicago/Turabian Style

Gopalaswamy, Radha, and Selvakumar Subbian. 2021. "Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis" International Journal of Molecular Sciences 22, no. 7: 3773. https://doi.org/10.3390/ijms22073773

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