tetano
Editor, Senior Moderator
Respiration
. 2021 Jan 22;1-11.
doi: 10.1159/000512063. Online ahead of print.
Early Use of Corticosteroid May Prolong SARS-CoV-2 Shedding in Non-Intensive Care Unit Patients with COVID-19 Pneumonia: A Multicenter, Single-Blind, Randomized Control Trial
Xiao Tang[SUP] 1 [/SUP], Ying-Mei Feng[SUP] 2 [/SUP], Ji-Xiang Ni[SUP] 3 [/SUP], Jia-Ying Zhang[SUP] 2 [/SUP], Li-Min Liu[SUP] 4 [/SUP], Ke Hu[SUP] 5 [/SUP], Xiu-Zhi Wu[SUP] 6 [/SUP], Ji-Xian Zhang[SUP] 7 [/SUP], Jun-Wen Chen[SUP] 8 [/SUP], Jian-Chu Zhang[SUP] 9 [/SUP], Jian Su[SUP] 3 [/SUP], Yu-Lei Li[SUP] 4 [/SUP], Yang Zhao[SUP] 5 [/SUP], Jiao Xie[SUP] 7 [/SUP], Zhou Ding[SUP] 8 [/SUP], Xin-Liang He[SUP] 9 [/SUP], Wen Wang[SUP] 6 [/SUP], Rong-Hua Jin[SUP] 2 [/SUP], Huan-Zhong Shi[SUP] 6 [/SUP], Bing Sun[SUP] 6 [/SUP]
Affiliations
Abstract
Background: There is still no clinical evidence available to support or to oppose corticosteroid treatment for coronavirus disease 2019 (COVID-19) pneumonia.
Objective: To investigate the efficacy and safety of corticosteroid given to the hospitalized patients with COVID-19 pneumonia.
Methods: This was a prospective, multicenter, single-blind, randomized control trial. Adult patients with COVID-19 pneumonia who were admitted to the general ward were randomly assigned to either receive methylprednisolone or not for 7 days. The primary end point was the incidence of clinical deterioration 14 days after randomization.
Results: We terminated this trial early because the number of patients with COVID-19 pneumonia in all the centers decreased in late March. Finally, a total of 86 COVID-19 patients underwent randomization. There was no difference of the incidence of clinical deterioration between the methylprednisolone group and control group (4.8 vs. 4.8%, p = 1.000). The duration of throat viral RNA detectability in the methylprednisolone group was 11 days (interquartile range, 6-16 days), which was significantly longer than that in the control group (8 days [2-12 days], p = 0.030). There were no significant differences between the 2 groups in other secondary outcomes. Mass cytometry discovered CD3+ T cells, CD8+ T cells, and NK cells in the methylprednisolone group which were significantly lower than those in the control group after randomization (p < 0.05).
Conclusions: From this prematurely closed trial, we found that the short-term early use of corticosteroid could suppress the immune cells, which may prolong severe acute respiratory syndrome coronavirus 2 shedding in patients with COVID-19 pneumonia.
Trial registration: ClinicalTrials.gov, NCT04273321.
Keywords: Coronavirus disease 2019; Corticosteroid; Outcome; Pneumonia; Virus shedding.
. 2021 Jan 22;1-11.
doi: 10.1159/000512063. Online ahead of print.
Early Use of Corticosteroid May Prolong SARS-CoV-2 Shedding in Non-Intensive Care Unit Patients with COVID-19 Pneumonia: A Multicenter, Single-Blind, Randomized Control Trial
Xiao Tang[SUP] 1 [/SUP], Ying-Mei Feng[SUP] 2 [/SUP], Ji-Xiang Ni[SUP] 3 [/SUP], Jia-Ying Zhang[SUP] 2 [/SUP], Li-Min Liu[SUP] 4 [/SUP], Ke Hu[SUP] 5 [/SUP], Xiu-Zhi Wu[SUP] 6 [/SUP], Ji-Xian Zhang[SUP] 7 [/SUP], Jun-Wen Chen[SUP] 8 [/SUP], Jian-Chu Zhang[SUP] 9 [/SUP], Jian Su[SUP] 3 [/SUP], Yu-Lei Li[SUP] 4 [/SUP], Yang Zhao[SUP] 5 [/SUP], Jiao Xie[SUP] 7 [/SUP], Zhou Ding[SUP] 8 [/SUP], Xin-Liang He[SUP] 9 [/SUP], Wen Wang[SUP] 6 [/SUP], Rong-Hua Jin[SUP] 2 [/SUP], Huan-Zhong Shi[SUP] 6 [/SUP], Bing Sun[SUP] 6 [/SUP]
Affiliations
- PMID: 33486496
- DOI: 10.1159/000512063
Abstract
Background: There is still no clinical evidence available to support or to oppose corticosteroid treatment for coronavirus disease 2019 (COVID-19) pneumonia.
Objective: To investigate the efficacy and safety of corticosteroid given to the hospitalized patients with COVID-19 pneumonia.
Methods: This was a prospective, multicenter, single-blind, randomized control trial. Adult patients with COVID-19 pneumonia who were admitted to the general ward were randomly assigned to either receive methylprednisolone or not for 7 days. The primary end point was the incidence of clinical deterioration 14 days after randomization.
Results: We terminated this trial early because the number of patients with COVID-19 pneumonia in all the centers decreased in late March. Finally, a total of 86 COVID-19 patients underwent randomization. There was no difference of the incidence of clinical deterioration between the methylprednisolone group and control group (4.8 vs. 4.8%, p = 1.000). The duration of throat viral RNA detectability in the methylprednisolone group was 11 days (interquartile range, 6-16 days), which was significantly longer than that in the control group (8 days [2-12 days], p = 0.030). There were no significant differences between the 2 groups in other secondary outcomes. Mass cytometry discovered CD3+ T cells, CD8+ T cells, and NK cells in the methylprednisolone group which were significantly lower than those in the control group after randomization (p < 0.05).
Conclusions: From this prematurely closed trial, we found that the short-term early use of corticosteroid could suppress the immune cells, which may prolong severe acute respiratory syndrome coronavirus 2 shedding in patients with COVID-19 pneumonia.
Trial registration: ClinicalTrials.gov, NCT04273321.
Keywords: Coronavirus disease 2019; Corticosteroid; Outcome; Pneumonia; Virus shedding.