Prednisone, a type of corticosteroid, often raises questions when individuals face health concerns like a COVID-19 infection. The decision to use prednisone for COVID-19 is complex and requires careful consideration by a medical professional. This is due to the drug’s potent effects on the body and the varied ways COVID-19 can manifest. Medical guidance is always necessary to determine if prednisone is appropriate.
What Prednisone Is
Prednisone is a synthetic corticosteroid, a man-made drug designed to mimic cortisol, a hormone naturally produced by the adrenal glands. It functions as a powerful anti-inflammatory agent, reducing swelling and redness throughout the body. Prednisone also acts as an immunosuppressant, decreasing the activity of the immune system.
It works by binding to specific receptors within cells, which then alters gene expression. This leads to a reduction in inflammatory chemicals and a dampening of immune cell activity. While beneficial for various inflammatory and autoimmune conditions, its immunosuppressive properties are a significant consideration when dealing with infections.
When Prednisone is Used for COVID-19
Prednisone, or similar corticosteroids like dexamethasone, is recommended for patients with severe COVID-19 who are hospitalized and require supplemental oxygen or mechanical ventilation. These medications help moderate the body’s excessive inflammatory response to the virus, often called a “cytokine storm.” This overactive immune response can cause significant damage to the lungs and other organs.
Corticosteroids dampen this inflammatory cascade, reducing lung injury and improving patient outcomes. For instance, studies have shown that dexamethasone can reduce deaths in patients with severe COVID-19 by about 20% and also lessen the need for mechanical ventilation. Treatment typically lasts 7 to 10 days, with specific dosages varying based on the steroid used. For example, dexamethasone is often given at 6 mg orally or intravenously once daily for up to 10 days. Prednisolone may be given at 40 mg orally once a day for 10 days, or hydrocortisone at 50 mg intravenously every 8 hours for 10 days.
Corticosteroids are not recommended for individuals with mild or moderate COVID-19 who do not require supplemental oxygen. In these less severe cases, suppressing the early immune response could potentially hinder the body’s ability to fight off the virus, prolonging viral clearance and increasing the risk of other infections.
Why Self-Medicating is Dangerous
Self-prescribing or taking prednisone without medical guidance carries significant risks, especially with COVID-19. Prednisone, even when used appropriately, can cause various side effects.
These include increased blood sugar levels, which may trigger or worsen diabetes, and elevated blood pressure. Mood changes, such as feelings of depression or euphoria, sleep disturbances, and difficulty with memory or concentration are also possible. The drug can also weaken the immune system, making an individual more susceptible to other infections or potentially prolonging the duration of viral shedding if used in mild COVID-19 cases. Other side effects include weight gain, fluid retention, thin skin, and slower wound healing. A healthcare professional must assess a patient’s overall health, existing medical conditions, and current medications to determine if prednisone is a safe and appropriate treatment.
If You Are Already on Prednisone and Get COVID
Individuals already taking prednisone for other medical conditions, such as autoimmune diseases, asthma, or chronic inflammatory conditions, should not abruptly stop their prescribed medication if they contract COVID-19. Suddenly discontinuing prednisone can lead to serious withdrawal symptoms, including severe fatigue, weakness, body aches, and joint pain. It can also cause a flare-up of the underlying condition for which the prednisone was prescribed.
Instead, immediately contact your prescribing doctor or healthcare provider for specific guidance. The doctor will assess the situation and determine if any dosage adjustments or specific management strategies are needed in light of the COVID-19 infection. In some cases, if a patient on long-term prednisone develops COVID-19 symptoms, their dose may need to be temporarily increased to support the body’s stress response, particularly if their adrenal function is compromised.