Corticosteroids for dengue infection
Dengue is a disease caused by a virus transmitted by mosquitoes, occurring in many resource-limited countries, and children are often most severely affected. Most infected patients will recover with mild symptoms, but a few progress to severe dengue and may die. There is no specific treatment for dengue, but some clinicians provide corticosteroids at an early stage to prevent progression to severe dengue disease; and some treat patients with dengue-related shock with corticosteroids to improve survival. It is important to summarise the effects of corticosteroids in dengue.
We conducted a search up to 6 January 2014 and included eight studies which enrolled 948 participants in total. Four studies of corticosteroids in the treatment of dengue-related shock assessed if corticosteroids could improve survival, but these studies were small and older than 20 years. The evidence we found is of very low quality and do not provide any reliable evidence for corticosteroids for treating dengue-related shock. Four trials evaluated whether corticosteroids provided at an early stage of dengue could prevent development of complications of severe dengue. These trials were more recent, but data were insufficient to be sure whether corticosteroids have an effect on the course of the disease.
Zhang, F.; Kramer, C.V. Corticosteroids for dengue infection. Cochrane Database of Systematic Reviews (2014) Issue 7, Art. No.: CD003488. [DOI: 10.1002/14651858.CD003488.pub3]