Outcome of early short-course corticosteroids in hospitalized patients with coronavirus disease-2019 (COVID-19): A report from a Saudi Arabian hospital.

Abstract

Background: The efficacy of corticosteroid use in patients with acute respiratory illness due to coronavirus disease-2019 (COVID-19) is unclear. In this study, we describe the clinical course of COVID-19 patients who received early course of corticosteroid treatment in patients with severe respiratory distress secondary to COVID-19.

Materials and methods: The clinical course of 30 COVID-19 patients admitted to King Fahad Military Medical Complex in Dhahran from the period of late March 2020 till June 2020 was assessed and described. All the 30 patients received steroids. Data on demographics, medical history, laboratory findings, chest radiology, medication use, and clinical outcomes were extracted from patients' records. Data was entered and analyzed with SPSS software.

Results: A total of 30 patients admitted with COVID-19 were included. The mean age 52.53 years (SD=16.31) with a range from 22-98 years; 73.3% were males. About two-thirds of the patients at least had comorbidities; most common were diabetes (46.7%) and hypertension (46.7%), and chronic heart disease (16.7%). About 57% patients had fever, cough, and shortness of breath. The median C-reactive protein (CRP) level was 87.5 mg/dL (IQR 45.0 - 165.65); 46.7% had CRP levels >120 mg/dL. The median white blood cell, lymphocytes, and platelet counts were 4.39, 1.05, and 212 K/μL, respectively. All the patients received corticosteroids; 17 (56.7%) patients were given IV methylprednisolone and 13 (43.3%) received dexamethasone tablets. Of the total patients, 13 (43.3%) patients developed acute respiratory distress syndrome (ARDS); 17 (56.7%) required oxygen, 10 (33.3%) were admitted to Intensive Care Unit (ICU), and 7 (23.3%) required mechanical ventilation. All the patients improved and were discharged home well.

Conclusion: Early use of oral corticosteroids in patients with higher CRP levels may lead to better outcomes and may lower risk of transfer to ICU and use of mechanical ventilation.