Corticosteroids in the treatment of SARS-CoV-2 related lung disease

Aim. To explore the effectiveness of corticosteroids in patients with lung damage caused by SARS-CoV-2.Materials and methods. The retrospective study included patients with confirmed SARS-CoV-2 infection and lung damage diagnosed by computed tomography (CT), who was receiving low molecular weight he...

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Main Authors: V. T. Ivaschkin, O. Yu. Zolnikova, A. A. Svistunov, N. L. Dzhakhaya, N. D. Potskhverashvili, N. I. Kokina, E. R. Buklis, T. V. Roshchina, I. I. Komkova, M. Yu. Nadinskaia
Format: Article
Language:Russian
Published: Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University) 2020-12-01
Series:Сеченовский вестник
Subjects:
Online Access:https://www.sechenovmedj.com/jour/article/view/238
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author V. T. Ivaschkin
O. Yu. Zolnikova
A. A. Svistunov
N. L. Dzhakhaya
N. D. Potskhverashvili
N. I. Kokina
E. R. Buklis
T. V. Roshchina
I. I. Komkova
M. Yu. Nadinskaia
author_facet V. T. Ivaschkin
O. Yu. Zolnikova
A. A. Svistunov
N. L. Dzhakhaya
N. D. Potskhverashvili
N. I. Kokina
E. R. Buklis
T. V. Roshchina
I. I. Komkova
M. Yu. Nadinskaia
author_sort V. T. Ivaschkin
collection DOAJ
description Aim. To explore the effectiveness of corticosteroids in patients with lung damage caused by SARS-CoV-2.Materials and methods. The retrospective study included patients with confirmed SARS-CoV-2 infection and lung damage diagnosed by computed tomography (CT), who was receiving low molecular weight heparin (LMWH). 56 patients included in Group 1 received dexamethasone 4–12 mg/day for 8–10 days after admission to the hospital. 30 patients included in Group 2 (control group) had no dexamethasone treatment. The laboratory and instrumental data obtained from the patients under admission and for the 8–10th day of the treatment were analyzed. Hospital mortality was evaluated by Kaplan — Meier method. To predict a lethal outcome, we have used the logistic regression method. Results. By the 8–10th day of hospitalization, only in the Group 1, there was a statistically significant decrease in the volume of lung tissue lesions by CT (p = 0.027), fibrinogen concentration (p = 0.001). A statistically significant decrease of the C-reactive protein concentration was noted for the both groups. Oxygen therapy was more often needed in Group 2 (26 patients — 87%) in opposite to Group 1 (36 patients — 64%) (p = 0.028). Hospital mortality was 3.6% in Group 1 and 13.3% in Group 2 (p = 0.177). There was a trend towards an increase in patient survival in Group 1 between 18 and 28 days of hospitalization (Mantel — Cox test, p = 0.095). Age (p = 0.012), percentage of CT lesions at the time of admission (p = 0.020) and assignment to the dexamethasone group (p = 0.080) were included in the logistic regression equation.Conclusion. For the patients with SARS-CoV-2 lung damage, treatment with dexamethasone 4–12 mg, started from the first day of hospitalization additionally to LMWH, contributes to positive CT dynamics on the 8–10th day and decreases hospital mortality.
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spelling doaj.art-00fa4d4ee402444881bd2e7b7abbe6d72023-03-13T09:51:33ZrusFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Сеченовский вестник2218-73322658-33482020-12-01112192810.47093/2218-7332.2020.11.2.19-28136Corticosteroids in the treatment of SARS-CoV-2 related lung diseaseV. T. Ivaschkin0O. Yu. Zolnikova1A. A. Svistunov2N. L. Dzhakhaya3N. D. Potskhverashvili4N. I. Kokina5E. R. Buklis6T. V. Roshchina7I. I. Komkova8M. Yu. Nadinskaia9Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Aim. To explore the effectiveness of corticosteroids in patients with lung damage caused by SARS-CoV-2.Materials and methods. The retrospective study included patients with confirmed SARS-CoV-2 infection and lung damage diagnosed by computed tomography (CT), who was receiving low molecular weight heparin (LMWH). 56 patients included in Group 1 received dexamethasone 4–12 mg/day for 8–10 days after admission to the hospital. 30 patients included in Group 2 (control group) had no dexamethasone treatment. The laboratory and instrumental data obtained from the patients under admission and for the 8–10th day of the treatment were analyzed. Hospital mortality was evaluated by Kaplan — Meier method. To predict a lethal outcome, we have used the logistic regression method. Results. By the 8–10th day of hospitalization, only in the Group 1, there was a statistically significant decrease in the volume of lung tissue lesions by CT (p = 0.027), fibrinogen concentration (p = 0.001). A statistically significant decrease of the C-reactive protein concentration was noted for the both groups. Oxygen therapy was more often needed in Group 2 (26 patients — 87%) in opposite to Group 1 (36 patients — 64%) (p = 0.028). Hospital mortality was 3.6% in Group 1 and 13.3% in Group 2 (p = 0.177). There was a trend towards an increase in patient survival in Group 1 between 18 and 28 days of hospitalization (Mantel — Cox test, p = 0.095). Age (p = 0.012), percentage of CT lesions at the time of admission (p = 0.020) and assignment to the dexamethasone group (p = 0.080) were included in the logistic regression equation.Conclusion. For the patients with SARS-CoV-2 lung damage, treatment with dexamethasone 4–12 mg, started from the first day of hospitalization additionally to LMWH, contributes to positive CT dynamics on the 8–10th day and decreases hospital mortality.https://www.sechenovmedj.com/jour/article/view/238coronavirus infectioncytokine stormcorticosteroidslow molecular weight heparininterleukin 6c-reactive proteincomputed tomography
spellingShingle V. T. Ivaschkin
O. Yu. Zolnikova
A. A. Svistunov
N. L. Dzhakhaya
N. D. Potskhverashvili
N. I. Kokina
E. R. Buklis
T. V. Roshchina
I. I. Komkova
M. Yu. Nadinskaia
Corticosteroids in the treatment of SARS-CoV-2 related lung disease
Сеченовский вестник
coronavirus infection
cytokine storm
corticosteroids
low molecular weight heparin
interleukin 6
c-reactive protein
computed tomography
title Corticosteroids in the treatment of SARS-CoV-2 related lung disease
title_full Corticosteroids in the treatment of SARS-CoV-2 related lung disease
title_fullStr Corticosteroids in the treatment of SARS-CoV-2 related lung disease
title_full_unstemmed Corticosteroids in the treatment of SARS-CoV-2 related lung disease
title_short Corticosteroids in the treatment of SARS-CoV-2 related lung disease
title_sort corticosteroids in the treatment of sars cov 2 related lung disease
topic coronavirus infection
cytokine storm
corticosteroids
low molecular weight heparin
interleukin 6
c-reactive protein
computed tomography
url https://www.sechenovmedj.com/jour/article/view/238
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AT oyuzolnikova corticosteroidsinthetreatmentofsarscov2relatedlungdisease
AT aasvistunov corticosteroidsinthetreatmentofsarscov2relatedlungdisease
AT nldzhakhaya corticosteroidsinthetreatmentofsarscov2relatedlungdisease
AT ndpotskhverashvili corticosteroidsinthetreatmentofsarscov2relatedlungdisease
AT nikokina corticosteroidsinthetreatmentofsarscov2relatedlungdisease
AT erbuklis corticosteroidsinthetreatmentofsarscov2relatedlungdisease
AT tvroshchina corticosteroidsinthetreatmentofsarscov2relatedlungdisease
AT iikomkova corticosteroidsinthetreatmentofsarscov2relatedlungdisease
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