Methylprednisolone accelerate chest computed tomography absorption in COVID-19: A three-centered retrospective case control study from China

Table 1 Patient Demographic Characteristics

Indicator		Control group (n = 32)	Glucocorticoid group (n = 38)	summation	χ2 or Hc value	P value
Gender	F	15	15	30	0.389	0.533
	M	17	23	40
Underlying diseases	N	18	23	41	0.131	0.717
	Y	14	15	29
Hypertension	N	24	30	54	0.154	0.695
	Y	8	8	16
Type 2 diabetes	N	28	31	59	0.460	0.498
	Y	4	7	11
Classification	Common type	20	22	42	0.154	0.695
	Severe type	12	16	28
Fever	N	8	4	12	2.562	0.109
	Y	24	34	58
Cough	N	11	13	24	0	0.988
	Y	21	25	46
Polypnea	N	28	26	54	3.586	0.058
	Y	4	12	16
Fatigue	N	22	30	52	0.946	0.331
	Y	10	8	18
Muscle soreness	N	25	36	61	2.924	0.087
	Y	7	2	9
Poor appetite	N	30	34	64	0.043	0.835
	Y	2	4	6
Chest distress	N	29	38	67	1.787	0.181
	Y	3	0	3
Chest pain	N	31	37	68		1
	Y	1	1	2
Diarrhea	N	31	37	68		1
	Y	1	1	2
Throatpain	N	31	38	69		0.457
	Y	1	0	1

F: Female; M: Male.

Table 2 Comparison of age, the time of medication in the two groups (mean ± SD)

Indicator	Control group	Corticosteroid group	t value	P value
Age (yr)	62.84 ± 13.97	59.05 ± 13.95	1.132	0.262
The time of medication (d)	7.66 ± 2.29	6.82 ± 1.84	1.668	0.101

Table 3 The relationship between duration, dose of methylprednisolone uses and CT improvement in the corticosteroid group (mean ± SD)

Indicator	Non-obvious absorption group (n = 4)	Obvious absorption group (n = 34)	t value	P value
Duration of methylprednisolone use (d)	6.0 ± 2.0	6.44 ± 1.86	-0.445	0.659
Total methylprednisolone dose (mg)	210.0 ± 66.33	239.15 ± 86.09	-0.652	0.519
Daily methylprednisolone dose (mg)	35.72 ± 4.95	38.55 ± 13.17	-0.422	0.676

Table 4 The results of severe acute respiratory syndrome coronavirus 2 RNA and chest computerized tomography absorbtion

Indicator		Control group	Corticosteroid group	Summation	χ2 or Hc value	P-value
SARS-CoV-2 RNA before medication	N	21	28	49	0.537	0.464a
	P	11	10	21
SARS-CoV-2 RNA after medication	N	30	37	67	0.023	0.879a
	P	2	1	3
CT absorption degree after medication	No absorption	13	0	13	41.681	< 0.001b
	Slightly absorption	15	4	19
	Obvious absorption	4	34	38

^aThere was no statistically difference in the negative conversion rate of severe acute respiratory syndrome coronavirus 2 nucleic acid between the two groups.

^bThere was significant difference in CT absorption degree between the two groups.

N: Negtive; P: Positive; CT: Computerized tomography; No absorption: No change in inflammatory range; Slightly absorption: The range of inflammation is absorbed than before, less than 25%; Obvious absorption: The range of inflammation is absorbed than before, more than 25%.

Table 5 Comparison of the total clearance time of severe acute respiratory syndrome coronavirus 2 nucleic acid in the two groups (mean ± SD)

Indicator	Control group	Corticosteroid group	t value	P value
The total clearance time (d)	22.13 ± 7.66	20.89 ± 7.70	0.667	0.507

Table 6 Comparison of laboratory results between the two groups before and after the medication (mean ± SD)

Indicator	Group	Before the medication	After the medication
Lymphocyte	Control group	1.35 ± 0.39	1.58 ± 0.44
	Corticosteroid group	1.34 ± 0.54	1.61 ± 0.62
ESR	Control group	25.22 ± 18.41	15.41 ± 9.67
	Corticosteroid group	25.71 ± 14.74	13.79 ± 8.24
LDH	Control group	171.66 ± 50.70	136.06 ± 36.80
	Corticosteroid group	226.13 ± 82.36	187.05 ± 68.53
SF	Control group	344.69 ± 209.42	202.22 ± 109.76
	Corticosteroid group	428.28 ± 249.29	255.19 ± 105.59

ESR: Erythrocyte sedimentation rate; LDH: Lactate dehydrogenase; SF: Serum ferritin.

Table 7 Comparison of laboratory results between the two groups before and after the medication (median)

Indicator	group	Before medication	After medication
hs-CRP	Control group	2.38 (1.12-10.96)	1.57 (1.33-3.20)
	Corticosteroid group	5.65 (1.57-22.0)	2.75 (0.87-9.0)
IL-6	Control group	8.29 (6.81-11.14)	6.60 (5.64-8.38)
	Corticosteroid group	10.30 (7.78-13.08)	8.21 (6.26-9.79)
CK-MB	Control group	0.60 (0.40-1.15)	0.60 (0.40-0.90)
	Corticosteroid group	6.0 (0.90-8.80)	4.25 (0.80-6.90)
D-dimer	Control group	0.80 (0.40-1.05)	0.54 (0.20-0.80)
	Corticosteroid group	1.14 (0.85-1.89)	0.89 (0.57-1.08)

hs-CRP: Hypersensitive C-reactive protein; IL-6: Interleukin-6; CK-MB: Creatine kinase-MB.

Table 8 Comparison of different indicators between the two groups by repeated-measures analysis

Indicator	Group		Time		Group × Time
	F value	P value	F value	P value	F value	P value
Lymphocyte	0.013	0.909	21.331	< 0.001	0.203	0.654
ESR	0.038	0.846	66.617	< 0.001	0.627	0.431
LDH	13.725	< 0.001	48.610	< 0.001	0.106	0.746
SF	3.152	0.080	61.862	< 0.001	0.582	0.448

ESR: Erythrocyte sedimentation rate; LDH: Lactate dehydrogenase; SF: Serum ferritin.

Table 9 Comparison of different indicators between the two groups by using generalized linear mixed model

Indicator	Group		Time		Group × Time
	F value	P value	F value	P value	F value	P value
hs-CRP	2.376	0.128	5.237	0.025	0.005	0.945
IL6	0.022	0.882	13.798	< 0.001	0.787	0.378
CK-MB	29.785	< 0.001	10.998	0.001	1.429	0.236
D-dimer	11.266	0.001	18.322	< 0.001	2.926	0.092

hs-CRP: Hypersensitive C-reactive protein; IL-6: Interleukin-6; CK-MB: Creatine kinase-MB.

Table 10 The adverse reaction of corticosteroids

	Control group, n = 32 (%)	Corticosteroid group, n = 38 (%)
Gastrointestinal bleeding	0	0
Secondary infection	0	0
Mental disorders	0	0
Elevated blood glucose	0 (0%)	11 (28.95%)
Diabetic ketoacidosis	0	0
Hypertension	0	0
Sever electrolyte disorders	0	0