Xiong B, He LM, Qin YY, Du H, Zhan Z, Zhou YH, Chen YK, Zhang A. Effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19: A retrospective cohort study. World J Clin Cases 2021; 9(15): 3546-3558 [PMID: 34046454 DOI: 10.12998/wjcc.v9.i15.3546]
Corresponding Author of This Article
An Zhang, MD, PhD, Chief Doctor, Professor, Department of Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing 400010, China. 300704@hospital.cqmu.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 26, 2021; 9(15): 3546-3558 Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3546
Effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19: A retrospective cohort study
Bin Xiong, Li-Min He, Yuan-Yuan Qin, Hu Du, Zhu Zhan, Yi-Hong Zhou, Yao-Kai Chen, An Zhang
Bin Xiong, Hu Du, Zhu Zhan, An Zhang, Department of Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Li-Min He, Department of Cardiology, The First Branch of The First Affiliated Hospital, Chongqing Medical University, Chongqing 400015, China
Yuan-Yuan Qin, Yi-Hong Zhou, Yao-Kai Chen, Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
Author contributions: Xiong B and He LM contributed to the writing of the manuscript; Zhang A and Chen YK conceived and designed the experiments; Du H, Zhan Z and Xiong B collected the epidemiological and clinical data; Xiong B and He LM analyzed the data; Qin YY, Zhou YH, Chen YK and Zhang A revised the final manuscript; all authors read and approved the final manuscript.
Supported bythe Chongqing Special Research Project for Novel Coronavirus Pneumonia Prevention and Control, No. csct2020jscx-fyzxX0012 and No. csct2020jscx-fyzxX0005; and Emergency Research Project of COVID-19 of Chongqing Health Commission, No. 2020NCPZX04.
Institutional review board statement: This study was approved by the Ethics Commission of the Chongqing Public Health Medical Center, No.2020-025-KY.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. Written informed consent was waived by the Ethics Committee of the designated hospital.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: An Zhang, MD, PhD, Chief Doctor, Professor, Department of Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing 400010, China. 300704@hospital.cqmu.edu.cn
Received: January 5, 2021 Peer-review started: January 5, 2021 First decision: January 17, 2021 Revised: January 21, 2021 Accepted: March 6, 2021 Article in press: March 6, 2021 Published online: May 26, 2021 Processing time: 125 Days and 20.4 Hours
Abstract
BACKGROUND
The effectiveness of adjunctive corticosteroid use in patients with coronavirus disease 2019 (COVID-19) remains inconclusive.
AIM
To investigate the effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19.
METHODS
We conducted a retrospective analysis of the difference in several outcomes between patients with severe COVID-19 who received corticosteroid therapy (the corticosteroid group) and patients with severe COVID-19 who did not receive corticosteroid therapy (the non-corticosteroid group).
RESULTS
Seventy-five patients were included in this study. Of these, 47 patients were in the corticosteroid group and 28 patients were in the non-corticosteroid group. There were no differences between the two groups in the total length of hospital stay, the length of intensive care unit stay, high-flow oxygen days, non-invasive ventilator days, invasive ventilation days, and mortality rate. Total lesion volume ratio, consolidation volume ratio and ground-glass opacity volume ratio in the corticosteroid group decreased significantly on day 14, while those in the non-corticosteroid group did not show a significant decrease.
CONCLUSION
Our results show that adjunctive corticosteroid use did not significantly improve clinical outcomes in severe COVID-19 patients, but might promote the absorption of pulmonary lesions. Larger multicenter randomized controlled studies may be needed to confirm this.
Core Tip: Corticosteroids have been used in the treatment of severe acute respiratory syndrome, Middle East respiratory syndrome and coronavirus disease 2019 (COVID-19). Many studies believe that corticosteroids have an inhibitory effect on inflammatory factors caused by viruses. In this study, 75 patients with severe COVID-19 were studied and divided into either the treatment group or the control group according to corticosteroid use. We found that adjunctive corticosteroid use did not significantly improve clinical outcomes in severe COVID-19 patients, but might promote the absorption of pulmonary lesions.
