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Response to: ‘Correspondence on ‘Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated cytokine storm syndrome: results of the CHIC study’’ by De Santis et al
  1. Sofia Ramiro1,2,
  2. Rémy L M Mostard3,
  3. Robert B M Landewé1,4
  1. 1 Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, Limburg, The Netherlands
  2. 2 Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
  3. 3 Department of Pulmonology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
  4. 4 Rheumatology & Clinical Immunology, Amsterdam Universitair Medische Centra, Duivendrecht, Noord-Holland, The Netherlands
  1. Correspondence to Dr Sofia Ramiro, Rheumatology, Leiden University Medical Center, 2300 RC Leiden, Zuid-Holland, The Netherlands; sofiaramiro{at}

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We read with interest the letter from De Santis et al 1 on our COVID-19 High-intensity Immunosuppression in Cytokine storm syndrome (CHIC) study.2 We thank De Santis et al for sharing their word of caution on the widespread use of glucocorticoids that is indeed very relevant. We totally agree that (at least so far) it has only been demonstrated that patients with severe COVID-19 who need to be hospitalised benefit from treatment with systemic glucocorticoids, either in the form of methylprednisolone or dexamethasone.2 3 As emphasised by De Santis et al, no evidence has been …

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  • Handling editor Josef S Smolen

  • Contributors SR drafted the response. All authors reviewed and approved the final response.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

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