Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
Respir Investig. 2022 Mar;60(2):241-247. doi: 10.1016/j.resinv.2021.11.001. Epub 2021 Nov 26.
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2, has been a significant concern worldwide since its outbreak in December 2019. Various treatments are being researched and developed, and there are reports that dexamethasone has reduced the mortality rate and improved the clinical course of critically ill patients with COVID-19. In this study, we examined the clinical efficacy of corticosteroid therapy for patients with COVID-19 in our hospital during the first wave of infections.
We retrospectively reviewed the medical records of patients with COVID-19 who were treated with or without corticosteroid therapy at the National Center for Global Health and Medicine in Japan between February and April 2020. The primary outcome was improvement in the patients' clinical course using a seven-category ordinal scale. We collected data on patient characteristics, treatment, and clinical course, and compared them between two groups: the steroid-using group and the non-steroid-using group.
Between February and April 2020, 110 patients were diagnosed with COVID-19. Despite poor conditions during admission into the steroid group, there were no statistical differences in clinical course between both groups, as measured using the scale. There were no statistical differences between the two groups in the number of days to fever resolution or negative polymerase chain reaction results.
There was no difference in the clinical course between both groups. Because of the difference in background, corticosteroids may potentially make the clinical course of severely ill patients similar to that of mildly ill patients.
由严重急性呼吸系统综合征冠状病毒 2 引起的 2019 年冠状病毒病（COVID-19）自 2019 年 12 月爆发以来一直是全球关注的焦点。正在研究和开发各种治疗方法，有报道称地塞米松降低了 COVID-19 重症患者的死亡率并改善了其临床过程。在本研究中，我们检查了我院在感染第一波期间 COVID-19 患者皮质类固醇治疗的临床疗效。
我们回顾性分析了 2020 年 2 月至 4 月期间在日本国立全球卫生与医学研究中心接受或未接受皮质类固醇治疗的 COVID-19 患者的病历。主要结局是使用七分类等级量表评估患者临床过程的改善。我们收集了患者特征、治疗和临床过程的数据，并将两组数据进行比较：使用激素组和未使用激素组。
2020 年 2 月至 4 月期间，共诊断出 110 例 COVID-19 患者。尽管激素组患者入院时情况较差，但两组间的临床过程评分无统计学差异。两组间发热消退或聚合酶链反应结果转为阴性的天数无统计学差异。
两组间的临床过程无差异。由于背景的差异，皮质类固醇可能使重症患者的临床过程与轻症患者相似。
