Department of Microbiology, Faculty of Medicine, Istanbul Atlas University, Istanbul 34008, Turkey.
Department of Internal Medicine, Faculty of Medicine, Istanbul Atlas University, Istanbul 34008, Turkey.
Viruses. 2024 Sep 12;16(9):1453. doi: 10.3390/v16091453.
Coronavirus disease 2019 (COVID-19) is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress and preterm delivery are the two major complications induced by SARS-CoV-2 infection during pregnancy. In the presence of dyspnea, the use of systemic corticosteroids was recommended in pregnant and non-pregnant groups. Our primary aim was to investigate the effect of early-onset steroid treatment on mortality and adverse effects in pregnant women with COVID-19. Our secondary aim was to investigate the effect of steroid treatment on the length of hospital stay and intensive care unit (ICU) stay, and duration of treatment. The study also investigated infection, preterm birth, and ideal body weight (lbw) in newborns.
In this retrospective study, 253 patients were divided into three groups according to steroid administration. In Group 1 patients (n:112), treatment was started at the time of hospitalization. In Group 2 patients (n:90), treatment was started at least 24 h after hospitalization. Group 3 consisted of patients (n:51) who did not receive steroid treatment. Methylprednisolone (32 mg/day) was given to pregnant patients with a gestational age below 24 weeks or above 34 weeks, and dexametazone (6 mg/day) was given in four doses followed by 32 mg/day methylprednisolone for the others (whose baby was at a gestational age of 24 weeks and above but less than 34 weeks).
The hospital stay, ICU stay, and steroid administration time were significantly lower in the Group 1 when compared to the others ( < 0.05). The steroid treatment requirement was 4.4 days in Group 1 and 5.7 days in Group 2 ( < 0.05). While no death was observed in Group 1, one patient died in Group 2 and three patients died in Group 3. There was no difference between the groups in terms of complications, including preterm labor.
No death was also observed with early-onset treatment. Early-onset treatment may be beneficial for fewer hospitalizations, fewer ICU stays, and less mechanical ventilation requirement in pregnant women with COVID-19. In addition, with early treatment, the total number of steroid administration days was reduced, which is important in terms of reducing the risk of side effects.
新型冠状病毒病（COVID-19）是由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的疾病。急性呼吸窘迫和早产是 SARS-CoV-2 感染引起的孕妇的两个主要并发症。在出现呼吸困难的情况下，建议在孕妇和非孕妇群体中使用全身皮质类固醇。我们的主要目的是研究早期类固醇治疗对 COVID-19 孕妇死亡率和不良影响的影响。我们的次要目的是研究类固醇治疗对住院时间、重症监护病房（ICU）入住时间和治疗时间的影响。该研究还调查了感染、早产和新生儿的理想体重（lbw）。
在这项回顾性研究中，根据类固醇给药将 253 名患者分为三组。在第 1 组患者（n=112）中，治疗在住院时开始。在第 2 组患者（n=90）中，治疗在住院后至少 24 小时开始。第 3 组包括未接受类固醇治疗的患者（n=51）。对于妊娠 24 周以下或 34 周以上的孕妇，给予甲泼尼龙（32 mg/天）；对于妊娠 24 周以上但不满 34 周的孕妇，给予地塞米松（6 mg/天），分 4 次给予，然后给予甲泼尼龙 32 mg/天。
与其他组相比，第 1 组的住院时间、ICU 入住时间和类固醇给药时间显著降低（<0.05）。第 1 组的类固醇治疗需求为 4.4 天，第 2 组为 5.7 天（<0.05）。第 1 组未观察到死亡，第 2 组有 1 例死亡，第 3 组有 3 例死亡。各组在并发症方面无差异，包括早产。
早期治疗也未观察到死亡。早期治疗可能对 COVID-19 孕妇的住院时间减少、入住 ICU 时间减少和机械通气需求减少有益。此外，早期治疗减少了类固醇给药天数，这对于降低副作用风险很重要。
