Clinical efficacy of glucocorticoid on the treatment of patients with COVID-19 pneumonia: A single-center experience

Biomed Pharmacother. 2020 Oct:130:110529. doi: 10.1016/j.biopha.2020.110529. Epub 2020 Jul 28.

Abstract

The aim of the present study was to identify the clinical efficacy of glucocorticoid therapy on the treatment of patients with Coronavirus Disease 2019 (COVID-19) pneumonia. Clinical and laboratory parameters were collected from 308 patients with COVID-19 pneumonia from the fever clinic of Wuhan Pulmonary Hospital (Wuhan City, Hubei Province, China) between January 14, 2020 and February 9, 2020, of which 216 patients received low-dose (equivalent of methylprednisolone 0.75-1.5 mg/kg/d) glucocorticoid treatment. The effect of glucocorticoid on imaging progress, adverse events, nucleic acid results and the outcomes were investigated. Lymphocyte count and C-reactive protein (CRP) significantly differed between the glucocorticoid therapy and non-glucocorticoid therapy groups. Compared with the non-glucocorticoid therapy group, glucocorticoid therapy did not significantly influence the clinical course of COVID-19 pneumonia, including imaging progress and the time duration for negative transformation of nucleic acid. Glucocorticoid therapy did not significantly influence the outcomes nor the adverse events of COVID-19 pneumonia. For the treatment of COVID-19 pneumonia, systemic and in-depth investigation is needed to determine the timing and dosage of glucocorticoids needed to inhibit overwhelming inflammatory response and not the protective immune response to COVID-19 pneumonia.

Keywords: COVID-19; Clinical course; Glucocorticoid therapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus* / isolation & purification
  • COVID-19
  • COVID-19 Drug Treatment
  • COVID-19 Testing
  • Clinical Laboratory Techniques
  • Coinfection / etiology
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / drug therapy*
  • Female
  • Humans
  • Male
  • Methylprednisolone / adverse effects
  • Methylprednisolone / therapeutic use*
  • Middle Aged
  • Pandemics*
  • Pharynx / virology
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / drug therapy*
  • Prednisolone / adverse effects
  • Prednisolone / therapeutic use*
  • RNA, Viral / analysis
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • RNA, Viral
  • Prednisolone
  • Methylprednisolone