key: cord-0834333-hy2wkp62
authors: Waterhouse, Jasmin V.; Hull, James H.; Linch, Mark
title: Corticosteroids for Urological Cancer Care During Coronavirus Disease 2019. Treat or Not to Treat?
date: 2020-04-21
journal: Eur Urol
DOI: 10.1016/j.eururo.2020.04.027
sha: 48f8785bf4f0c8905b13732c1dca3be0e2af5539
doc_id: 834333
cord_uid: hy2wkp62

Currently, the official World Health Organization guidance is not to start corticosteroids, but there is no robust evidence of risk in patients with cancer and coronavirus disease 2019. A risk-benefit analysis should be performed for each patient on the use of steroids in cancer care.

as part of anticancer regimens, supportive care, and toxicity 23 management. Here, we outline some guidance to health 24 care professionals to assist with a risk-benefit analysis of 25 corticosteroid therapy for uro-oncology patients during the 26 COVID-19 pandemic. 27 Case fatality rates of COVID-19 in patients with cancer 28 was reported to be twice that of the overall fatality rate infection (75% vs 43%) [4] . In response to this heightened in the presence of short-course, high-dose steroids, primary 77 antibody generation does not seem to be impaired [9] .

The advice from the WHO and CDC to avoid corticosteroids 78 in COVID-19 is based on concerns that viral replication might 79 be prolonged and clearance delayed [1, 2] , and is largely 

management-of-severe-acute-respiratory-infection-when-novel-138 coronavirus-(ncov)-infection-is-suspected

Characteristics of and important lessons from 142 the coronavirus disease 2019 (COVID-19) outbreak in China

Control and Prevention

Cancer patients in SARS-CoV-2 infection: 145 a nationwide analysis in China

A randomised phase 146

non-severe COVID-19

Dexamethasone-154 induced immunosuppression: mechanisms and implications for 155 immunotherapy

SARS: systematic review of 159 treatment effects

Corticosteroids for Urological Cancer Care During Coronavirus Disease 2019. Treat or Not to Treat?