Efficacy of corticosteroids in treatment of hospitalized patients with novel coronavirus infection (COVID-19)


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Abstract

The aim of the study was the examination of the efficacy of a short corticosteroid usage course in patients with moderate COVID-19 run relatively to the dynamics of generalized inflammation. Material and methods. A retrospective analysis of patients (n=61) admitted from October 1 to November 30, 2020 with COVID-19 was carried out. The diagnosis, assessment of severity and corticosteroids prescribing procedure was carried out in accordance with the recommendations «Prevention, diagnosis and treatment of new coronavirall infection (COVID-19), version 8». Results. Male patients prevailed among the studied patients - 52 (85,2%), concomitant pathology was represented in 32 patients (52,4%), 56 (91,8%) persons recovered, 3 (4,9%) died. 31 patients received corticosteroids: 30 - dexamethasone in a course dose of 113,3±5,9 (40-216) mg, 1 - methylprednisolone 1 g for 3 days. Treatment with these medicines was started on 7,4±0,5 (2-14) days of the disease or on 2,2±0,3 (1-9) days of hospitalization; the duration of administration was 7,4±0,4 (2-12 ) days. When comparing the groups that received and did not receive corticosteroids, significant differences in indicators of inflammation (body temperature, C-reactive protein level), respiratory disorders (respiratory rate, oxygen saturation), lymphopenia and thrombocytopenia were revealed. After the withdrawal of corticosteroids, 23 (73%) patients did not require an escalation of anti-inflammatory therapy, their number of lymphocytes (by 83%), platelets (by 74%) increased, C-reactive protein decreased twice, which indicates a significant effect of these medicines at the intensity of inflammation, macrophage activation and bone marrow response. In 8 from 30 (27%) patients, treatment with corticosteroids was insufficient, which required an escalation of therapy. Conclusion. A retrospective analysis of clinical and laboratory data from patients with moderate COVID-19 course showed a significant decrease in the activity of generalized inflammation after a short course of corticosteroids.

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About the authors

Dmitry O. Efremov

A.A. Vishnevsky 3rd Central Military Clinical Hospital of the Ministry of Defense of Russia

Email: efremov-d24@mail.ru
head of the infectious disease center, branch No. 1 143409, Krasnogorsk, 11 Svetlaya Str

Vladimir B. Beloborodov

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia

Email: belvb1070@mail.ru
MD, professor, head of the Department of infectious diseases 125284, Moscow, 5/7 2nd Botkinsky proezd Str

Ilya A. Kovalev

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia

Email: ilynemsa@gmail.com
postgraduate student of the Department of infectious diseases 125284, Moscow, 5/7 2nd Botkinsky proezd Str

Andrey V. Meshkov

A.A. Vishnevsky 3rd Central Military Clinical Hospital of the Ministry of Defense of Russia

Email: 3hospital_f1@mil.ru
head of branch No. 1 143409, Krasnogorsk, 11 Svetlaya Str

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