tetano
Editor, Senior Moderator
Eur J Pharmacol
. 2020 Sep 14;173556.
doi: 10.1016/j.ejphar.2020.173556. Online ahead of print.
Corticosteroid therapy is associated with the delay of SARS-CoV-2 clearance in COVID-19 patients
Rui Huang[SUP] 1 [/SUP], Chuanwu Zhu[SUP] 2 [/SUP], Jian Wang[SUP] 1 [/SUP], Leyang Xue[SUP] 3 [/SUP], Chunyang Li[SUP] 4 [/SUP], Xiaomin Yan[SUP] 1 [/SUP], Songping Huang[SUP] 5 [/SUP], Biao Zhang[SUP] 6 [/SUP], Li Zhu[SUP] 2 [/SUP], Tianmin Xu[SUP] 7 [/SUP], Fang Ming[SUP] 5 [/SUP], Yun Zhao[SUP] 8 [/SUP], Juan Cheng[SUP] 9 [/SUP], Huaping Shao[SUP] 10 [/SUP], Xiang-An Zhao[SUP] 11 [/SUP], Dawen Sang[SUP] 9 [/SUP], Haiyan Zhao[SUP] 10 [/SUP], Xinying Guan[SUP] 12 [/SUP], Xiaobing Chen[SUP] 13 [/SUP], Yuxin Chen[SUP] 14 [/SUP], Jie Wei[SUP] 15 [/SUP], Rahma Issa[SUP] 15 [/SUP], Longgen Liu[SUP] 16 [/SUP], Xuebing Yan[SUP] 17 [/SUP], Chao Wu[SUP] 18 [/SUP]
Affiliations
Abstract
The impact of corticosteroid treatment on virological course of coronavirus disease 2019 (COVID-19) patients remains unclear. This study aimed to explore the association between corticosteroid and viral clearance in COVID-19. The clinical data of COVID-19 patients from 10 hospitals of Jiangsu, China, were retrospectively collected. Cox regression and Kaplan-Meier analysis were used to analyze the adverse factors of virus clearance. Of the 309 COVID-19 patients, eighty-nine (28.8%) patients received corticosteroid treatment during hospitalization. Corticosteroid group showed higher C-reactive protein (median 11.1 vs. 7.0 mg/l, P = 0.018) and lower lymphocytes (median 0.9 vs. 1.4 ? 10[SUP]9[/SUP]/l, P < 0.001) on admission. Fever (93.3% vs. 65.0%, P < 0.001) and cough (69.7% vs. 57.3%, P = 0.043) were more common in corticosteroid group. The proportions of patients with severe illness (34.8% vs. 1.8%, P < 0.001), respiratory failure (25.8% vs. 1.4%, P < 0.001), acute respiratory distress syndrome (4.5% vs. 0%, P = 0.002), and admission to ICU (20.2% vs. 0.9%, P < 0.001) were significantly higher in corticosteroid group than non-corticosteroid group. The duration of virus clearance (median 18.0 vs. 16.0 days, P < 0.001) and hospitalization (median 17.0 vs. 15.0 days, P < 0.001) were also significantly longer in corticosteroid group than non-corticosteroid group. Treated with corticosteroid (Hazard ratio
, 0.698; 95% confidence interval [CI], 0.512 to 0.951; P = 0.023) was an adverse factor of the clearance of SARS-CoV-2, especially for male patients (HR, 0.620; 95% CI, 0.408 to 0.942; P = 0.025). The cumulative probability of SARS-CoV-2 clearance was lower in corticosteroid group (P < 0.001). Corticosteroid treatment may delay the SARS-CoV-2 clearance of COVID-19 patients and should be used with cautions.
Keywords: Coronavirus disease 2019; Corticosteroid; Virus clearance.
. 2020 Sep 14;173556.
doi: 10.1016/j.ejphar.2020.173556. Online ahead of print.
Corticosteroid therapy is associated with the delay of SARS-CoV-2 clearance in COVID-19 patients
Rui Huang[SUP] 1 [/SUP], Chuanwu Zhu[SUP] 2 [/SUP], Jian Wang[SUP] 1 [/SUP], Leyang Xue[SUP] 3 [/SUP], Chunyang Li[SUP] 4 [/SUP], Xiaomin Yan[SUP] 1 [/SUP], Songping Huang[SUP] 5 [/SUP], Biao Zhang[SUP] 6 [/SUP], Li Zhu[SUP] 2 [/SUP], Tianmin Xu[SUP] 7 [/SUP], Fang Ming[SUP] 5 [/SUP], Yun Zhao[SUP] 8 [/SUP], Juan Cheng[SUP] 9 [/SUP], Huaping Shao[SUP] 10 [/SUP], Xiang-An Zhao[SUP] 11 [/SUP], Dawen Sang[SUP] 9 [/SUP], Haiyan Zhao[SUP] 10 [/SUP], Xinying Guan[SUP] 12 [/SUP], Xiaobing Chen[SUP] 13 [/SUP], Yuxin Chen[SUP] 14 [/SUP], Jie Wei[SUP] 15 [/SUP], Rahma Issa[SUP] 15 [/SUP], Longgen Liu[SUP] 16 [/SUP], Xuebing Yan[SUP] 17 [/SUP], Chao Wu[SUP] 18 [/SUP]
Affiliations
- PMID: 32941927
- DOI: 10.1016/j.ejphar.2020.173556
Abstract
The impact of corticosteroid treatment on virological course of coronavirus disease 2019 (COVID-19) patients remains unclear. This study aimed to explore the association between corticosteroid and viral clearance in COVID-19. The clinical data of COVID-19 patients from 10 hospitals of Jiangsu, China, were retrospectively collected. Cox regression and Kaplan-Meier analysis were used to analyze the adverse factors of virus clearance. Of the 309 COVID-19 patients, eighty-nine (28.8%) patients received corticosteroid treatment during hospitalization. Corticosteroid group showed higher C-reactive protein (median 11.1 vs. 7.0 mg/l, P = 0.018) and lower lymphocytes (median 0.9 vs. 1.4 ? 10[SUP]9[/SUP]/l, P < 0.001) on admission. Fever (93.3% vs. 65.0%, P < 0.001) and cough (69.7% vs. 57.3%, P = 0.043) were more common in corticosteroid group. The proportions of patients with severe illness (34.8% vs. 1.8%, P < 0.001), respiratory failure (25.8% vs. 1.4%, P < 0.001), acute respiratory distress syndrome (4.5% vs. 0%, P = 0.002), and admission to ICU (20.2% vs. 0.9%, P < 0.001) were significantly higher in corticosteroid group than non-corticosteroid group. The duration of virus clearance (median 18.0 vs. 16.0 days, P < 0.001) and hospitalization (median 17.0 vs. 15.0 days, P < 0.001) were also significantly longer in corticosteroid group than non-corticosteroid group. Treated with corticosteroid (Hazard ratio
, 0.698; 95% confidence interval [CI], 0.512 to 0.951; P = 0.023) was an adverse factor of the clearance of SARS-CoV-2, especially for male patients (HR, 0.620; 95% CI, 0.408 to 0.942; P = 0.025). The cumulative probability of SARS-CoV-2 clearance was lower in corticosteroid group (P < 0.001). Corticosteroid treatment may delay the SARS-CoV-2 clearance of COVID-19 patients and should be used with cautions.
Keywords: Coronavirus disease 2019; Corticosteroid; Virus clearance.