Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430030, Hubei, China.
Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430030, Hubei, China.
Biomed Pharmacother. 2020 Oct;130:110529. doi: 10.1016/j.biopha.2020.110529. Epub 2020 Jul 28.
The aim of the present study was to identify the clinical efficacy of glucocorticoid therapy on the treatment of patients with Coronavirus Disease 2019 (COVID-19) pneumonia. Clinical and laboratory parameters were collected from 308 patients with COVID-19 pneumonia from the fever clinic of Wuhan Pulmonary Hospital (Wuhan City, Hubei Province, China) between January 14, 2020 and February 9, 2020, of which 216 patients received low-dose (equivalent of methylprednisolone 0.75-1.5 mg/kg/d) glucocorticoid treatment. The effect of glucocorticoid on imaging progress, adverse events, nucleic acid results and the outcomes were investigated. Lymphocyte count and C-reactive protein (CRP) significantly differed between the glucocorticoid therapy and non-glucocorticoid therapy groups. Compared with the non-glucocorticoid therapy group, glucocorticoid therapy did not significantly influence the clinical course of COVID-19 pneumonia, including imaging progress and the time duration for negative transformation of nucleic acid. Glucocorticoid therapy did not significantly influence the outcomes nor the adverse events of COVID-19 pneumonia. For the treatment of COVID-19 pneumonia, systemic and in-depth investigation is needed to determine the timing and dosage of glucocorticoids needed to inhibit overwhelming inflammatory response and not the protective immune response to COVID-19 pneumonia.
本研究旨在探讨糖皮质激素治疗 2019 冠状病毒病(COVID-19)肺炎患者的临床疗效。2020 年 1 月 14 日至 2 月 9 日,我们收集了 308 例来自中国湖北省武汉市肺科医院发热门诊的 COVID-19 肺炎患者的临床和实验室参数,其中 216 例患者接受了低剂量(相当于甲泼尼龙 0.75-1.5mg/kg/d)糖皮质激素治疗。研究了糖皮质激素对影像学进展、不良事件、核酸结果和结局的影响。糖皮质激素治疗组与非糖皮质激素治疗组之间的淋巴细胞计数和 C 反应蛋白(CRP)差异有统计学意义。与非糖皮质激素治疗组相比,糖皮质激素治疗并未显著影响 COVID-19 肺炎的临床病程,包括影像学进展和核酸转阴的时间。糖皮质激素治疗也未显著影响 COVID-19 肺炎的结局或不良事件。对于 COVID-19 肺炎的治疗,需要进行系统和深入的研究,以确定抑制过度炎症反应所需的糖皮质激素的时机和剂量,而不是对 COVID-19 肺炎的保护性免疫反应。