Retrospective study of low-to-moderate dose glucocorticoids on viral clearance in patients with novel coronavirus pneumonia
10.3760/cma.j.cn115673-20200225-00072
- VernacularTitle: 中低剂量糖皮质激素对新型冠状病毒肺炎患者病毒清除的回顾性分析研究
- Author:
Qin NI
1
;
Cheng DING
;
Yongtao LI
;
Hong ZHAO
;
Jun LIU
;
Xuan ZHANG
;
Yanfei CHEN
;
Yongzheng GUO
;
Liang YU
;
Hongzhen JU
;
Jingjing TAO
;
Ping YI
;
Guanjing LANG
;
Junwei SU
;
Ding SHI
;
Wenrui WU
;
Xiaoxin WU
;
Ling YU
;
Jifang SHENG
;
Kaijin XU
Author Information
1. State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
- Publication Type:Journal Article
- Keywords:
Coronavirus Infections;
COVID-19;
Glucocorticoid;
Virus clearance
- From:
Chinese Journal of Clinical Infectious Diseases
2020;13(0):E009-E009
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19.
Methods:A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg-1·d-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups.
Results:The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (P<0.05). The clinical conditions at hospital admission were different between the two groups (P<0.01). There were 52.0% critical ill patients in the glucocorticoid treatment group, compared to that of 71.4% normal patients in the control group. The median times from the onset tostable virologic conversion to negative in the two groups were 15 (IQR:13,20) days and 14 (IQR:12,20) days (P>0.05), and the difference was no statistically significant. The median times from onset to radiologic recovery were 13 (IQR: 11,15) days and 13 (IQR:12,17) days in the two groups, and there was no difference (P>0.05). In ordinary patients, the median timesfrom the onset tostable virologic conversion insputum were no difference (P>0.05), with 13 (IQR:11,18) days in the glucocorticoid group and 13 (IQR:12,15) days in the control group; The median times from onset to radiologic recovery in lungwere also no difference (P>0.05), with 12 (IQR: 10,15)days in the glucocorticoid group and 13 (IQR: 12,17) days inthe control group.
Conclusions:Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19. The glucocorticoid is not recommended since no effectiveness on accelerating the improvement of radiologic recovery in lung has been observed.
