Glucocorticoids could be safe in COVID-19; a case series

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus which has led to a pandemic. There is no approved treatment for coronavirus disease 2019 (COVID-19). Over time, physicians came to understand that in some severe patients, glucocorticoids could be considered as a second line treatment option. As there are a limited number of reports addressing the use of glucocorticoids (GCs) in patients with moderately severe COVID-19, this article presents the results in patients who referred to our national team and received glucocorticoids as part of their medication. This descriptive and prospective study iincludes 35 clinically-diagnosed moderate to severe COVID-19 cases in outpatient and inpatient settings. Patients received intravenous dexamethasone, oral prednisolone, and pulsed methylprednisolone. Demographic data, clinical signs and symptoms, laboratory and chest CT findings of patients were recorded. On average Men comprised 60% of this group of patients. On admission Lymphocyte counts were depleted in a majority of patients (54.3%). Shortness of breath, O2 sat, and respiratory rate improved 48 to 72 hours after administration of glucocorticoids. Almost all patients had favorable clinical courses were improved during treatment with glucocorticoids, except one who had superimposed bacterial and candida infection. CT scan findings showed bilateral peripheral patchy infiltrations with ground glass opacities as the dominant pattern of lung involvement (60%). One patient was admitted to the intensive care unit. The results of our study showed that the administration of glucocorticoids in the early stages of COVID-19 disease is not only effective, but is also safe and prevents the progression of the disease.