Risk-adapted Treatment Strategy For COVID-19 Patients

Int J Infect Dis. 2020 May;94:74-77. doi: 10.1016/j.ijid.2020.03.047. Epub 2020 Mar 27.

Abstract

Background: There are no clear expert consensus or guidelines on how to treat 2019 coronavirus disease (COVID-19). The objective of this study is to investigate the short-term effect of risk-adapted treatment strategy on patients with COVID-19.

Methods: We collected the medical records of 55 COVID-19 patients for analysis. We divided these patients into mild, moderate and severe groups, and risk-adapted treatment approaches were given according to the illness severity.

Results: Twelve patients were in mild group and 22 were in moderate group (non-severe group, n=34), and 21 patients were in severe group. At the end of the first two weeks after admission, clinical manifestations had completely despeared in 31(91.2%)patients in non-severe group, and 18(85.7%) patients in severe group (p=0.85). Both groups had a satisfied chest CT imaging recovery, which includes 22(64.7%) patients in non-severe group and 12(57.1%) patients in severe group recovered at least 50% of the whole leisions in the first week, and 28(82.4%) and 16(76.2%) recovered at least 75% in the second week, respectively. There were no significant differences in SARS-CoV-2 nucleic acid negativity (p=0.92). There were also no significant differences in the levels of SARS-CoV-2-IgM and IgG antibody production between the two groups (p=0.13, 0.62). There were 45 cases were discharged from the hospital, and no patients died at the time of this clinical analysis.

Conclusions: Risk-adapted treatment strategy was associated with significant clinical manifestations alleviation and clinical imaging recovery. In severe COVID-19 patients, early and short-term use of low-dose methylprednisolone was beneficial and did not delay SARS-CoV-2 nucleic acid clearance and influence IgG antibody production.

Keywords: COVID-19; antiviral treatment; low-dose corticosteroid; novel coronavirus pneumonia; risk-adapted treatment strategy.

MeSH terms

  • Adaptation, Physiological
  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / therapy*
  • Risk Factors
  • SARS-CoV-2
  • Tomography, X-Ray Computed