Have you incorporated the use of steroids for patients with severe community-acquired pneumonia?

Yes, the evidence is pointing toward starting steroids (hydrocortisone at 200mg total daily dose) early (in the first 24 hours) in patients with severe CAP who do NOT have influenza. In septic shock caused by CAP, steroid recs follow the septic shock guidelines. Dequin et al., PMID 36942789 showed that patients treated early with hydrocortisone had better survival rates at 28 and 90 days mortality. Patients should require at least high-flow oxygen supplementation or require ICU admission. Sometimes a high CRP level may also point in the same direction. The VA study that did not show a benefit in mortality treated patients with methyl-prednisolone later in their course.