Risks, interactions, prevention and more

Steroids, or corticosteroids, are a group of medications that are similar to a hormone called cortisol in your body. They reduce inflammation and are used to treat a variety of conditions, including:

Regular use of steroids can weaken your immune system and increase your risk of contracting COVID-19 or a more serious illness.

Corticosteroids differ from anabolic steroids, which are drugs that replicate the hormone testosterone. Although anabolic steroids have legitimate medical uses, people often use them recreationally to build muscle and improve athletic performance.

Anabolic steroid use has also been linked to worse COVID-19 outcomes.

Read on to learn how steroids work and how they affect your immune system.

Corticosteroids are man-made drugs that mimic the hormone cortisol. Your adrenal glands, located at the top of your kidneys, produce cortisol.

Corticosteroids are among those most commonly prescribed drugs worldwide. Nearly 1 percent of the world population uses long-term corticosteroid therapy as treatment.

The conditions they treat include:

Corticosteroids reduce inflammation in your body by binding to receptors that suppress the activity of your immune system.

According to the Centers for Disease Control and Prevention (CDC)long-term use of steroids can weaken your immune system and make you more likely to contract COVID-19 or other respiratory illnesses.

Long-term (or chronic) use of corticosteroids is associated with:

  • increased risk of upper respiratory tract infections
  • increased virus replication
  • delayed viral clearance
  • increased risk of secondary infection

In a previous 2020 study, researchers found that taking over 10 milligrams per day of the steroid prednisone was associated with a 2.05 times higher chance of hospitalization in people with rheumatoid arthritis.

Some steroids can potentially cause the antiviral drug remdesivir to be cleared from the body more quickly. This makes the drug less effective in treating COVID-19.

Athletes and bodybuilders commonly abuse anabolic steroids to enhance appearance or performance. Anabolic steroid use can alter the immune system and increase the risk of infection.

A Study 2022 found that current anabolic steroid use is a risk factor for COVID-19 severity.

In the study, current steroid use was associated with a five times greater likelihood of developing COVID-19. Current anabolic steroid use has also been associated with a higher likelihood of developing moderate to severe COVID-19.

If you have a medical condition that increases your chances of getting very sick from COVID-19, the CDC recommends talking to a doctor about how best to protect yourself.

Doctors decide whether to continue treatment with corticosteroids on a case-by-case basis. Your doctor is the best person to tell you if you should stop taking steroids or lower your dose. Up to 90 percent of people who take steroids for more than 60 days develop side effects.

You can also protect yourself by making sure your COVID-19 vaccines are up to date. You may be entitled to additional booster shots if you are considered immunocompromised.

Other ways you can protect yourself are:

  • Wear a KN95 or N95 mask in public areas or around sick people.
  • Stay 6 feet away from other people.
  • Avoid close contact with sick people.
  • Avoid poorly ventilated or crowded spaces.
  • Wash your hands frequently and for at least 20 seconds.

Here are some of the frequently asked questions about steroids and COVID-19.

Does the risk change depending on how I take steroids?

Oral or injected steroids are more likely to cause side effects such as immunosuppression than inhaled steroids or topical steroids. Side effects tend to increase with dose and duration of use.

Inhaled steroids generally cause fewer and milder side effects than oral corticosteroids.

Do steroids interfere with the COVID-19 vaccine?

according to a Study 2022There is an ongoing debate as to whether steroids decrease the effectiveness of vaccines, although there is no direct evidence to support this.

in one 2021 review of studiesFive out of six studies found evidence of successful vaccination in people taking steroids.

They concluded that, based on current evidence, it is reasonable to delay steroid injections for chronic pain by 1 to 2 weeks after vaccination and vaccination by 2 weeks after steroid interventions.

Can steroids be used to treat COVID-19?

According to the National Institutes of Health COVID-19 treatment guidelines, several high-quality studies suggest that corticosteroid therapy improves outcomes in people with COVID-19 who require oxygen therapy. This may be because they reduce the inflammatory response that leads to lung damage and dysfunction.

The most widely studied corticosteroid used to treat COVID-19 is dexamethasone. Researchers have also looked at other steroids such as hydrocortisone and methylprednisolone, but the evidence supporting the use of these drugs is not as strong.

A Study 2022 linked steroids with better results in younger people but not in older people.

Some studies have found evidence that steroids increase risk COVID-19-associated pulmonary aspergillosis (CAPA) in intensive care patients. CAPA is a fungal infection of the lungs that can increase the risk of death.

Steroids treat a variety of medical conditions. They work by reducing inflammation and suppressing your immune system. Taking steroids, especially in high doses, can make you more susceptible to contracting COVID-19.

Your doctor can best advise you on whether you should lower or reduce your dose. You can also reduce your chances of getting COVID-19 by taking preventive measures like regular hand washing and getting vaccinated.

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