Sheianov Mikhail V, Udalov Yurii D, Ochkin Sergei S, Bashkov Andrei N, Samoilov Aleksandr S
Department of Pulmonology, Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency of Russia, Moscow, RUS.
Management, Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency of Russia, Moscow, RUS.
Cureus. 2020 Jul 7;12(7):e9038. doi: 10.7759/cureus.9038.
We present the cases of three patients with severe, life-threatening coronavirus disease 2019 (COVID-19) who had failed to achieve substantial improvement on intial treatment. They subsequently received pulse therapy with methylprednisolone [1,000 mg/day intravenously (IV) for three consecutive days] and IV immunoglobulin (20 g/day). This treatment regimen was associated with a prompt resolution of respiratory failure, elimination of clinical manifestations of the cytokine release syndrome (CRS), and reversal of pulmonary CT changes. The treatment was generally safe and well-tolerated. There was no evidence of protracted persistence of the virus in the patients. Further randomized controlled trials are required to better understand the efficacy and safety of high-dose methylprednisolone and IV immunoglobulin, separately or in combination with each other, in the treatment of severe, life-threatening COVID-19.
我们报告了3例患有严重、危及生命的2019冠状病毒病（COVID-19）的患者，他们在初始治疗后未能取得实质性改善。随后，他们接受了甲泼尼龙冲击治疗（连续3天静脉注射1000mg/天）和静脉注射免疫球蛋白（20g/天）。该治疗方案与呼吸衰竭迅速缓解、细胞因子释放综合征（CRS）临床表现消除以及肺部CT改变逆转相关。该治疗总体安全且耐受性良好。没有证据表明病毒在患者体内长期持续存在。需要进一步的随机对照试验，以更好地了解高剂量甲泼尼龙和静脉注射免疫球蛋白单独或联合治疗严重、危及生命的COVID-19的疗效和安全性。
