Ma Yiming, Zeng Huihui, Zhan Zijie, Lu Huanhuan, Zeng Zihang, He Chenjie, Liu Xiangming, Chen Chen, Qin Qingwu, He Jia, Zhou Zhiguo, Huang Peng, Jiang Mingyan, Deng Dingding, Liao Xin, Xiang Zhi, Huang Xiaoying, Chen Yan, Chen Ping
Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
Front Pharmacol. 2020 Aug 12;11:1198. doi: 10.3389/fphar.2020.01198. eCollection 2020.
Coronavirus disease 2019 (COVID-19) has developed into a worldwide pandemic. This study aimed to retrospectively describe the use of corticosteroids in treating COVID-19.
For this multicenter retrospective study, medical records from 488 symptomatic COVID-19 patients were reviewed. Patients were divided into severe and nonsevere groups. Baseline characteristics, signs and symptoms, laboratory findings, treatments, and disease outcomes were compared. Specific data for corticosteroid treatment were further analyzed.
Four hundred fifty COVID-19 patients were included in this study, including 82 severe patients and 368 nonsevere cases. Out of the 450 patients, 126 (28.0%) received corticosteroid treatment. In the 126 patients treated with corticosteroids, the median daily dose of corticosteroid therapy was 56.6 [interquartile range (IQR): 40.0-78.4] mg and median corticosteroid therapy duration was 5.0 (IQR: 3.0-7.0) days. Among nonsevere cases, patients treated with corticosteroids were significantly older in comparison with patients who did not receive corticosteroid treatment (<0.01); the proportion of patients receiving antibiotic therapy in the corticosteroid group was significantly higher than that in the noncorticosteroid group (<0.001); hospitalization length and duration of viral shedding were significantly longer in patients in the corticosteroid group than in the noncorticosteroid group after adjusting for age, sex, and comorbidities (<0.05). In severe cases, patients treated with corticosteroids were significantly older and comorbidities at admission were significantly more common in patients receiving corticosteroid treatment (<0.05); the proportion of patients receiving antibiotic therapy in the corticosteroid group was significantly higher than that in the noncorticosteroid group (<0.001); no significant difference in hospitalization length or viral shedding duration was found between two groups after adjusting for age, sex, and comorbidities (>0.05).
Our study indicates that corticosteroids are regarded as one of treatments in the general clinical practice of COVID-19. However, corticosteroid use may be accompanied by increased use of antibiotics, longer hospitalization, and prolonged viral shedding.
2019冠状病毒病（COVID-19）已发展成为全球大流行疾病。本研究旨在回顾性描述皮质类固醇在治疗COVID-19中的应用情况。
在这项多中心回顾性研究中，对488例有症状的COVID-19患者的病历进行了审查。将患者分为重症组和非重症组。比较了两组患者的基线特征、体征和症状、实验室检查结果、治疗方法及疾病转归。对皮质类固醇治疗的具体数据进行了进一步分析。
本研究共纳入450例COVID-19患者，其中重症患者82例，非重症患者368例。在这450例患者中，126例（28.0%）接受了皮质类固醇治疗。在接受皮质类固醇治疗的126例患者中，皮质类固醇治疗的每日中位剂量为56.6[四分位数间距（IQR）：40.0 - 78.4]mg，皮质类固醇治疗的中位疗程为5.0（IQR：3.0 - 7.0）天。在非重症病例中，接受皮质类固醇治疗的患者与未接受皮质类固醇治疗的患者相比，年龄显著更大（P<0.01）；皮质类固醇治疗组接受抗生素治疗的患者比例显著高于非皮质类固醇治疗组（P<0.001）；在调整年龄、性别和合并症后，皮质类固醇治疗组患者的住院时间和病毒 shedding 持续时间显著长于非皮质类固醇治疗组（P<0.05）。在重症病例中，接受皮质类固醇治疗的患者年龄显著更大，入院时合并症在接受皮质类固醇治疗的患者中更为常见（P<0.05）；皮质类固醇治疗组接受抗生素治疗的患者比例显著高于非皮质类固醇治疗组（P<0.001）；在调整年龄、性别和合并症后，两组患者的住院时间或病毒 shedding 持续时间无显著差异（P>0.05）。
我们的研究表明，皮质类固醇在COVID-19的一般临床实践中被视为治疗方法之一。然而，使用皮质类固醇可能伴随着抗生素使用增加、住院时间延长和病毒 shedding 时间延长。
