Efficacy of corticosteroids in treatment of hospitalized patients with novel coronavirus infection (COVID-19)


DOI: https://dx.doi.org/10.18565/therapy.2021.4.25-33

Efremov D.O., Beloborodov V.B., Kovalev I.A., Meshkov A.V.

1) A.A. Vishnevsky 3rd Central Military Clinical Hospital of the Ministry of Defense of Russia, Krasnogorsk; 2) Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia, Moscow
Abstract. The aim of the study was the examination of the efficacy of a short corticosteroid usage course in patients with moderate COVID-19 run relatively to the dynamics of generalized inflammation.
Material and methods. A retrospective analysis of patients (n=61) admitted from October 1 to November 30, 2020 with COVID-19 was carried out. The diagnosis, assessment of severity and corticosteroids prescribing procedure was carried out in accordance with the recommendations «Prevention, diagnosis and treatment of new coronavirall infection (COVID-19), version 8».
Results. Male patients prevailed among the studied patients – 52 (85,2%), concomitant pathology was represented in 32 patients (52,4%), 56 (91,8%) persons recovered, 3 (4,9%) died. 31 patients received corticosteroids: 30 – dexamethasone in a course dose of 113,3±5,9 (40–216) mg, 1 – methylprednisolone 1 g for 3 days. Treatment with these medicines was started on 7,4±0,5 (2–14) days of the disease or on 2,2±0,3 (1–9) days of hospitalization; the duration of administration was 7,4±0,4 (2–12 ) days. When comparing the groups that received and did not receive corticosteroids, significant differences in indicators of inflammation (body temperature, C-reactive protein level), respiratory disorders (respiratory rate, oxygen saturation), lymphopenia and thrombocytopenia were revealed. After the withdrawal of corticosteroids, 23 (73%) patients did not require an escalation of anti-inflammatory therapy, their number of lymphocytes (by 83%), platelets (by 74%) increased, C-reactive protein decreased twice, which indicates a significant effect of these medicines at the intensity of inflammation, macrophage activation and bone marrow response. In 8 from 30 (27%) patients, treatment with corticosteroids was insufficient, which required an escalation of therapy.
Conclusion. A retrospective analysis of clinical and laboratory data from patients with moderate COVID-19 course showed a significant decrease in the activity of generalized inflammation after a short course of corticosteroids.
Keywords: moderate COVID-19 course, hospitalized patients, COVID-19, corticosteroids
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About the Autors

Dmitry O. Efremov, head of the infectious disease center, branch No. 1 of A.A. Vishnevsky 3rd Central Military Clinical Hospital of the Ministry of Defense of Russia. Address: 143409, Krasnogorsk, 11 Svetlaya Str. Tel.: +7 (911) 179-96-44. E-mail: efremov-d24@mail.ru
Vladimir B. Beloborodov, MD, professor, head of the Department of infectious diseases, Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 125284, Moscow, 5/7 2nd Botkinsky proezd Str. Tel.: +7 (925) 891-35-30. E-mail: belvb1070@mail.ru
Ilya A. Kovalev, postgraduate student of the Department of infectious diseases, Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 125284, Moscow, 5/7 2nd Botkinsky proezd Str. Tel.: +7 (903) 762-86-00. E-mail: ilynemsa@gmail.com
Andrey V. Meshkov, head of branch No. 1 of A.A. Vishnevsky 3rd Central Military Clinical Hospital of the Ministry of Defense of Russia. Address: 143409, Krasnogorsk, 11 Svetlaya Str. Tel.: +7 (916) 440-34-96. E-mail: 3hospital_f1@mil.ru


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