Adrenocortical response in influenza as a pattern for using corticosteroids in COVID-19

In patients with influenza hospitalized during the epidemic (Moscow, 1977) blood levels of 11-oxycorticosteroids (11-OX) and tyrosine were determined. Due to specific features of tyrosine metabolism, its blood level is virtually determined by two factors: the functional competence of hepatocytes and tissue provision with glucocorticoids. Similar hypertyrosinemia was revealed in 11 patients with a severe complicated course of the disease and in 9 of 22 patients with a relatively light course of influenza. At virtually the same “intoxication start” the adrenocortical response was dramatically different in “severe” and “relatively light” patients: at the beginning of the disease in the “relatively light” patients there was a pronounced increase in the 11-OX level, whereas in the “severe” patients the level of 11-OX retained at the level normal for the physiological rest conditions. Thus, the clinical course of the acute infection was associated with the presence or absence of the well-timed adrenocortical response.

It seems that corticosteroid preparations would be most useful at the beginning of acute infection – as imitation of the full-value adrenocortical response. Possibly, the same would be useful for treatment of COVID-19.