Well, it is the virus that creates the inflammation by causing the body's immune response to massively overcompensate.
The fact is that the older a person is, the more the immune system overreacts and causes the infamous cytokine storm - which is why it does not harm any healthy children or healthy young adults at all, and why the elderly are the most at risk.
As to your statement that corticosteroids do not work for COVID, the medical science says otherwise:
Quote:
Corticosteroids are hormones that are naturally produced from the adrenal cortex and are involved in a variety of physiological processes, such as inflammatory regulation, stress, and immunological response, protein, and carbohydrate metabolism. As a result, corticosteroids are critical in the management of autoimmune, allergic, malignant, and many inflammatory disorders [
1].
In COVID-19-related severe acute respiratory syndrome, viral escape of cellular immune response and the cytokine storm is important in pathophysiology and clinical consequences. Dysregulation of cytokine and invasion of inflammatory myeloid cells results in lung inflammation and severe sequelae, such as acute respiratory distress syndrome, respiratory failure, sepsis, multi-organ failure, and death [
2].
Corticosteroids have significant anti-inflammatory and anti-fibrotic effects, which may play a role in reducing pulmonary inflammation, especially in severe pneumonia and in advanced stages of COVID-19 disease [3]
Close quote.
Since the cytokine storm is what kills the COVID patient, corticosteroids, which reduce cytokines, is obviously an important treatment:
Quote:
Corticosteroids have been proven to reduce cytokine releases, particularly interleukin-6 (IL-6) in serum and bronchoalveolar lavage in vivo, as well as CRP and neutrophil count in bronchoalveolar aspirates in people treated with corticosteroids [
8].
Close quote.
Here’s a COVID patient and the successful treatment that included corticosteroids, which brought his 02 level back to normal:
His WBC count was slightly raised with lymphopenia and high C-reactive protein (CRP). He was given IV antibiotics (meropenem, cefepime, and moxifloxacin)
with IV steroid therapy (low-dose dexamethasone 6 mg once a day). On day 2 after admission, he was given IV remdesivir once a day for five days. His D-dimer level was also increased, and he was given subcutaneous enoxaparin 0.4cc once a day for seven days. During the hospital stay, he suffered from hemoptysis and apathy. However, after receiving treatment for 10 days, his shortness of breath improved. His oxygen saturation returned to around 92-93% without oxygen therapy,
and IV steroid was changed to oral medication with a tapering dose. The inflammatory parameters CRP and erythrocyte sedimentation rate (ESR) returned to the normal range after 14 days of treatment, and he was discharged on day 17. Repeated CXR was done on day 30 at the follow-up visit and witnessed complete radiographic resolution of lung opacities (Figure
(Figure22).
Source: The Role of Steroids in the Management of COVID-19 Infection
As you can see, corticosteroids work for any inflammatory lung problem that involves the infamous cytokine storm, including COVID - just as I said previously.