Introduction: The severity of Sars-Cov-2 infection is associated with the development of acute respiratory distress syndrome (ARDS). The progression to ARDS appears to be driven by a major inflammatory mechanism potentially sensitive to corticosteroids. Observation: This article describes the case of an elderly patient was admitted to emergency departments for intense asthenia, accompanied by motor diarrhoea, dyspnoea with desaturation in ambient air, in a context of strong suspicion of infection linked to COVID-19. The article also reviews the existing literature on the diagnosis and treatment of this severe form of the disease. Conclusion: Corticosteroids, and in particular dexamethasone, have been shown to be effective in the management of patients with COVID-19, an oxygen-releasing disease.
References
[1]
RECOVERY Collaborative Group (2021) Dexamethasone in Hospitalized Patients with Covid-19. The New England Journal of Medicine, 384, 693-704. https://doi.org/10.1056/NEJMoa2021436
[2]
Muller, M., Bulubas, I. and Vogel, T. (2021) Les facteurs pronostiques dans la Covid-19. NPG Neurologie—Psychiatrie—Gériatrie, 21, 304-312. https://doi.org/10.1016/j.npg.2021.06.002
[3]
Nguyen, S., Major, K., Cochet, C., Bizzozzero, T., Barbarossa, L., Bosshard, W., et al. (2020) Infection COVID-19 chez les personnes agées en Suisse Romande: Un état des lieux entre croyances, convictions et certitudes. Revue Médicale Suisse, 16, 835-838. https://doi.org/10.53738/REVMED.2020.16.691.0835
[4]
Sacco, G., Brière, O., Asfar, M., Guérin, O., Berrut, G. and Annweiler, C. (2020) Symptômes du Covid-19 chez la personne agée: Revue systématique de la littérature biomédicale internationale. Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, 18, 135-140. https://doi.org/10.1684/pnv.2020.0863
[5]
Boureau, A.S., de Decker, L., Berrut, G. and Hanon, O. (2020) Pathologies cardiovasculaires et Covid-19: Particularités chez les personnes agées. Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, 18, 141-149. https://doi.org/10.1684/pnv.2020.0864
[6]
Mehta, P., McAuley, D.F., Brown, M., Sanchez, E., Tattersall, R.S. and Manson, J.J. (2020) COVID-19: Consider Cytokine Storm Syndromes and Immunosuppression. Lancet, 395, 1033-1034. https://doi.org/10.1016/S0140-6736(20)30628-0
[7]
Sterne, J.A.C., Diaz, J., Villar, J., et al. (2020) Corticosteroid Therapy for Critically Ill Patients with COVID-19: A Structured Summary of a Study Protocol for a Prospective Meta-Analysis of Randomized Trials. BMC, 21, Article No. 734. https://doi.org/10.1186/s13063-020-04641-3
[8]
Villar, J., Ferrando, C., Martínez, D., et al. (2020) Dexamethasone Treatment for the Acute Respiratory Distress Syndrome: A Multicentre, Randomised Controlled Trial. The Lancet Respiratory Medicine, 8, 267-276. https://doi.org/10.1016/S2213-2600(19)30417-5
[9]
The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group (2020) Association between Administration of Systemic Corticosteroids and Mortality among Critically Ill Patients with COVID-19: A Meta-Analysis. JAMA, 324, 1330-1341.
[10]
Organisation Mondiale de la Santé (2023) Traitements contre la COVID-19: Orientations évolutives. OMS, Genève.