Rana Muhammad A, Hashmi Mubashar, Qayyum Ahad, Pervaiz Rizwan, Saleem Muhammad, Munir Muhammad Faisal, Ullah Saif Muhammad Muneeb
Internal Medicine, Bahria International Hospital, Lahore, PAK.
Medical Education and Simulation, Bahria International Hospital, Lahore, PAK.
Cureus. 2020 Oct 12;12(10):e10918. doi: 10.7759/cureus.10918.
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the reason for the global pandemic that started from Wuhan, China, in December 2019, known as coronavirus diseases 2019 (COVID-19). Acute respiratory distress syndrome happened in COVID-19 not just because of uncontrolled viral replication but also because of an uncontrolled immune reaction from the host. That's why antiviral and anti-inflammatory treatments have become an increasing concern for clinicians. Methods A retrospective quasi-experimental study design was used to assess the effectiveness of methylprednisolone and dexamethasone in the improvement of PaO/FiO (P/F) ratio in COVID-19 patients. We included 60 participants for this study by using a convenient sampling technique and divided them into two groups with 30 patients in each group. Group 1 was given dexamethasone 8 mg twice daily, and group 1 given methylprednisolone 40 mg twice daily for eight days. We recorded C-reactive protein (CRP), serum ferritin level, and P/F ratio before administration of both drugs and after administration of drugs for eight days. We used the paired t-test to assess the effect of both drugs on the P/F ratio of participants. Results The initial mean CRP in group 1 was 110.34, which reduced to 19.45 after administration of dexamethasone; similarly, the CRP in group 2 was 108.65, which reduced to 43.82 after administering methylprednisolone for eight days. In P/F ratio improvement, the calculated significance value for dexamethasone (p=0.000) was less than the table value at 0.05 in all sections, p-value for methylprednisolone (p=0.009) was also less than the table value at 0.05, which shows that both dexamethasone and methylprednisolone were effective in improving P/F ratio. Calculated p-value for dexamethasone (p=0.000) was lower than the calculated p-value for methylprednisolone (p=0.009), which shows that dexamethasone is more effective as compare to methylprednisolone. Conclusions Steroid therapy is effective in controlling inflammation markers, and especially dexamethasone is significantly effective in improving the P/F ratio in COVID-19 patients.
引言 严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是2019年12月在中国武汉爆发的全球大流行的起因，即2019冠状病毒病（COVID-19）。COVID-19中出现急性呼吸窘迫综合征不仅是因为病毒复制不受控制，还因为宿主的免疫反应不受控制。这就是为什么抗病毒和抗炎治疗越来越受到临床医生的关注。
方法 采用回顾性准实验研究设计来评估甲泼尼龙和地塞米松对改善COVID-19患者的氧合指数（PaO₂/FiO₂，P/F）的有效性。我们采用方便抽样技术纳入了60名参与者，并将他们分为两组，每组30名患者。第1组每天两次给予8毫克地塞米松，第2组每天两次给予40毫克甲泼尼龙，持续8天。我们记录了两种药物给药前和给药8天后的C反应蛋白（CRP）、血清铁蛋白水平和P/F比值。我们使用配对t检验来评估两种药物对参与者P/F比值的影响。
结果 第1组最初的平均CRP为110.34，给予地塞米松后降至19.45；同样，第2组的CRP为108.65，给予甲泼尼龙8天后降至43.82。在P/F比值改善方面，地塞米松的计算显著性值（p = 0.000）在所有部分均小于0.05的表格值，甲泼尼龙的p值（p = 0.009）也小于0.05的表格值，这表明地塞米松和甲泼尼龙在改善P/F比值方面均有效。地塞米松的计算p值（p = 0.000）低于甲泼尼龙的计算p值（p = 0.009），这表明与甲泼尼龙相比，地塞米松更有效。
结论 类固醇疗法在控制炎症指标方面有效，尤其是地塞米松在改善COVID-19患者的P/F比值方面显著有效。
