tetano
Editor, Senior Moderator
J Nippon Med Sch
. 2022 Apr 11.
doi: 10.1272/jnms.JNMS.2022_89-409. Online ahead of print.
Efficacy of Corticosteroid Therapy in Non-severe COVID-19 Patients with Severe Risk Factors who do not Require Supplemental Oxygen
Toru Tanaka[SUP] 1 [/SUP], Yoshinobu Saito[SUP] 1 [/SUP], Takeru Kashiwada[SUP] 1 [/SUP], Shinji Nakamichi[SUP] 1 [/SUP], Masaru Matsumoto[SUP] 1 [/SUP], Akihiko Miyanaga[SUP] 1 [/SUP], Yosuke Tanaka[SUP] 1 [/SUP], Kazue Fujita[SUP] 1 [/SUP], Masahiro Seike[SUP] 1 [/SUP], Akihiko Gemma[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Although corticosteroids are expected to be a candidate therapy for coronavirus disease 2019 (COVID-19) through the suppression of cytokine production, the efficacy in non-severe patients who do not require supplemental oxygen remains controversial. The aim of this study was to investigate the efficacy of corticosteroid therapy for non-severe patients.
Methods: We performed a retrospective observational study for 10 patients with non-severe COVID-19 who received corticosteroid therapy at our institute between July 1, 2020, and January 31, 2021.
Results: The median age of the 10 patients was 60 years, and nine patients were male. Nine of the 10 patients had multiple comorbid conditions (e.g., hypertension, diabetes and obesity). Although blood oxygen saturation was maintained above 95%, all patients showed persistent fever and deterioration of their chest imaging findings. Thus, we decided to initiate corticosteroid treatment. The median duration from the onset of symptoms to the initiation of corticosteroid therapy was eight days. All patients used dexamethasone (6 mg/day) as corticosteroid therapy, and the median period was 7.5 days. After the start of corticosteroid therapy, all patients showed a rapid clinical improvement, and no patients showed severe progression.
Conclusion: The latest World Health Organization guidance recommends against corticosteroid treatment for non-severe patients. In this report, we showed that the early administration of corticosteroids during the non-critical phase, when oxygen supplementation is not required, was useful for the early improvement and prevention of severe disease in patients with risk factors for severe COVID-19 and worsening clinical symptoms.
Keywords: coronavirus disease 2019; corticosteroid therapy; non-severe; severe acute respiratory syndrome coronavirus 2.
. 2022 Apr 11.
doi: 10.1272/jnms.JNMS.2022_89-409. Online ahead of print.
Efficacy of Corticosteroid Therapy in Non-severe COVID-19 Patients with Severe Risk Factors who do not Require Supplemental Oxygen
Toru Tanaka[SUP] 1 [/SUP], Yoshinobu Saito[SUP] 1 [/SUP], Takeru Kashiwada[SUP] 1 [/SUP], Shinji Nakamichi[SUP] 1 [/SUP], Masaru Matsumoto[SUP] 1 [/SUP], Akihiko Miyanaga[SUP] 1 [/SUP], Yosuke Tanaka[SUP] 1 [/SUP], Kazue Fujita[SUP] 1 [/SUP], Masahiro Seike[SUP] 1 [/SUP], Akihiko Gemma[SUP] 1 [/SUP]
Affiliations
- PMID: 35400720
- DOI: 10.1272/jnms.JNMS.2022_89-409
Abstract
Background: Although corticosteroids are expected to be a candidate therapy for coronavirus disease 2019 (COVID-19) through the suppression of cytokine production, the efficacy in non-severe patients who do not require supplemental oxygen remains controversial. The aim of this study was to investigate the efficacy of corticosteroid therapy for non-severe patients.
Methods: We performed a retrospective observational study for 10 patients with non-severe COVID-19 who received corticosteroid therapy at our institute between July 1, 2020, and January 31, 2021.
Results: The median age of the 10 patients was 60 years, and nine patients were male. Nine of the 10 patients had multiple comorbid conditions (e.g., hypertension, diabetes and obesity). Although blood oxygen saturation was maintained above 95%, all patients showed persistent fever and deterioration of their chest imaging findings. Thus, we decided to initiate corticosteroid treatment. The median duration from the onset of symptoms to the initiation of corticosteroid therapy was eight days. All patients used dexamethasone (6 mg/day) as corticosteroid therapy, and the median period was 7.5 days. After the start of corticosteroid therapy, all patients showed a rapid clinical improvement, and no patients showed severe progression.
Conclusion: The latest World Health Organization guidance recommends against corticosteroid treatment for non-severe patients. In this report, we showed that the early administration of corticosteroids during the non-critical phase, when oxygen supplementation is not required, was useful for the early improvement and prevention of severe disease in patients with risk factors for severe COVID-19 and worsening clinical symptoms.
Keywords: coronavirus disease 2019; corticosteroid therapy; non-severe; severe acute respiratory syndrome coronavirus 2.