Effect of methylprednisolone in severe and critical COVID-19:Analysis of 102 cases  

作　　者：Hong-Ming Zhu Yan Li Bang-Yi Li Shuang Yang Ding Peng Xiaojiao Yang Xue-Lian Sun Mei Zhang 

机构地区：[1]Department of Gastroenterology,Xuanwu Hospital of Capital Medical University,Beijing 100053,China [2]Department of Pulmonology,Xuanwu Hospital of Capital Medical University,Beijing 100053,China [3]School of Human Nutrition,Faculty of Agricultural and Environmental Sciences,McGill University,Montreal,QC H9X 3V9,Canada [4]Department of Emergency Medicine,Xuanwu Hospital of Capital Medical University,Beijng 100053,China

出　　处：《World Journal of Clinical Cases》2020年第23期5952-5961,共10页世界临床病例杂志

摘　　要：BACKGROUND The coronavirus disease 2019(COVID-19)outbreak has brought great challenges to public health.Aggravation of COVID-19 is closely related to the secondary systemic inflammatory response.Glucocorticoids are used to control severe diseases caused by the cytokine storm,owing to their anti-inflammatory effects.However,glucocorticoids are a double-edged sword,as the use of large doses has the potential risk of secondary infection and long-term serious complications,and may prolong virus clearance time.Nonetheless,the risks and benefits of glucocorticoid adjuvant therapy for COVID-19 are inconclusive.AIM To determine the effect of methylprednisolone in severe and critically ill patients with COVID-19.METHODS This single-center retrospective study included 102 adult COVID-19 patients admitted to a ward of a designated hospital in Wuhan,Hubei Province from January to March 2020.All patients received general symptomatic treatment and organ function support,and were given different respiratory support measures according to their conditions.In case of deterioration,considering the hyperinflammatory state of the patients,methylprednisolone was intravenously administered at 0.75-1.5 mg/kg/d,usually for less than 14 d.Patient vital signs and oxygenation were closely monitored,in combination with imaging and routine blood tests such as C-reactive protein,biochemical indicators(liver and kidney function,myocardial enzymes,electrolytes,etc.),and coagulation function.Patient clinical outcomes were discharge or death.RESULTS A total of 102 severe and critically ill COVID-19 patients were included in this study.They were divided into treatment(69,67.6%)and control groups(33,32.4%)according to methylprednisolone use.Comparison of baseline data between the two groups showed that the treatment group patients had higher aspartic acid aminotransferase,globulin,hydroxybutyrate dehydrogenase,and lactate dehydrogenase.There was no significant difference in other baseline data between the two groups.With regard to prognosis,29(78.4%

关 键 词：COVID-19 GLUCOCORTICOIDS METHYLPREDNISOLONE Cytokine storm Coronavirus infections CYTOKINES 

分 类 号：R563.1[医药卫生—呼吸系统]