地塞米松在门诊SARS-CoV-2感染患者中的应用

M. Martínez-Zaldívar Moreno, E. Aguilera Maestre, P. Espinosa Barta, N. Navarro Ortiz, J. C. Callejas Rubio
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引用次数: 0

摘要

目的:评价我院门诊接受地塞米松治疗的SARS冠状病毒感染患者的临床演变。方法:回顾在初级保健处接受地塞米松治疗的SARS-CoV-2感染急性期患者的病历,无初始严重程度标准。我们描述临床人口学特征和放射学和细胞因子风暴的分析数据,以及它的最终演变。结果:共纳入9例患者,女性6例,男性3例,平均年龄56.6(34-74)岁。所有病例就诊的原因均为发热,从出现症状到就诊的平均时间为4(2-7)天。所有患者血氧饱和度与吸入氧分数的关系均大于450。其中5例患者影像学表现与COVID相符,4例未见浸润。没有患者有细胞因子风暴综合征的实验室数据。地塞米松推荐剂量为6mg /d,连用7天。3例需要住院,2例在使用地塞米松后第三天住院,1例在使用地塞米松后第四天住院。这些患者通过皮质类固醇和抗生素脉冲治疗解决了住院过程,不需要高流量氧气治疗或机械通气。结论:在没有住院标准的SARS-CoV-2感染患者中使用地塞米松似乎并不能预防进展为更严重形式的风险。在缺乏更多数据的情况下,在这些病例中使用地塞米松似乎是不可取的,除非有其他原因需要使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dexamethasone in outpatients with SARS-CoV-2 infection
Objective: To evaluate the clinical evolution of outpatients with SARS Cov-2 infection, who received dexamethasone in our Health Center. Methods: The medical records of the patients who were prescribed dexamethasone treatment from Primary Care, in the acute phase of the SARS-CoV-2 infection, were reviewed, without initial criteria of severity. We describe the clinical-demographic characteristics and the radiological and analytical data of the cytokine storm, as well as its final evolution. Results: a total of 9 patients were included, 6 women and 3 men with a mean age of 56.6 (34-74) years. The reason for consultation was fever in all cases, with a mean time of 4 (2-7) days from onset of symptoms to consultation. All patients presented a relationship between oxygen saturation and inspired oxygen fraction greater than 450. Out of these, 5 patients presented radiological findings compatible with COVID and no infiltrates were observed in 4. No patient had laboratory data for cytokine storm syndrome. The recommended dexamethasone dose was 6 mg/d for 7 days. In 3 cases, hospital admission was required, 2 on the third day and one on the fourth day after the start of dexamethasone. These patients resolved the in-hospital process with pulses of corticosteroids and antibiotics, without the need for high-flow oxygen therapy or mechanical ventilation. Conclusions: the use of dexamethasone in patients with SARS-CoV-2 infection without hospital admission criteria does not seem to prevent the risk of progression to more serious forms. In the absence of more data, the use of dexamethasone in these cases does not seem advisable, unless it is required for other reasons.
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