COVID-19 and Hyperinflammation: Role of Steroid in Mild Disease

Current COVID-19 has become a major public health problem because of its pandemicity, with wide spectrum of disease manifestation. SARS-COV-2 can have a varied clinical manifestation ranging from asymptomatic, mild symptomatic to severe disease like acute respiratory distress syndrome, cytokine storm, and multiorgan dysfunction. It has been described in literature that cytokine storm/hyperinflammation arises as result of dysregulated immune response leading to excessive release of various cytokines which causes multiorgan dysfunction. But there is paucity of literature describing the immune response and hyperinflammation in mild disease which may cause unremitting symptoms. Here we describe a case series of three patients with mild disease, who had persistent symptoms beyond 1 week and managed with low dose steroid after confirming it to be hyperinflammation. So it is imperative to detect the hyperinflammatory phase to halt the disease progression. Also we have discussed the role of immune system and role of steroid in COVID-19.