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Corticosteroids in the treatment of SARS-CoV-2 related lung disease

https://doi.org/10.47093/2218-7332.2020.11.2.19-28

Abstract

Aim. To explore the effectiveness of corticosteroids in patients with lung damage caused by SARS-CoV-2.

Materials and methods. The retrospective study included patients with confirmed SARS-CoV-2 infection and lung damage diagnosed by computed tomography (CT), who was receiving low molecular weight heparin (LMWH). 56 patients included in Group 1 received dexamethasone 4–12 mg/day for 8–10 days after admission to the hospital. 30 patients included in Group 2 (control group) had no dexamethasone treatment. The laboratory and instrumental data obtained from the patients under admission and for the 8–10th day of the treatment were analyzed. Hospital mortality was evaluated by Kaplan — Meier method. To predict a lethal outcome, we have used the logistic regression method.

Results. By the 8–10th day of hospitalization, only in the Group 1, there was a statistically significant decrease in the volume of lung tissue lesions by CT (p = 0.027), fibrinogen concentration (p = 0.001). A statistically significant decrease of the C-reactive protein concentration was noted for the both groups. Oxygen therapy was more often needed in Group 2 (26 patients — 87%) in opposite to Group 1 (36 patients — 64%) (p = 0.028). Hospital mortality was 3.6% in Group 1 and 13.3% in Group 2 (p = 0.177). There was a trend towards an increase in patient survival in Group 1 between 18 and 28 days of hospitalization (Mantel — Cox test, p = 0.095). Age (p = 0.012), percentage of CT lesions at the time of admission (p = 0.020) and assignment to the dexamethasone group (p = 0.080) were included in the logistic regression equation.

Conclusion. For the patients with SARS-CoV-2 lung damage, treatment with dexamethasone 4–12 mg, started from the first day of hospitalization additionally to LMWH, contributes to positive CT dynamics on the 8–10th day and decreases hospital mortality.

About the Authors

V. T. Ivaschkin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Vladimir T. Ivaschkin, MD, PhD, DMSc, Professor, Academician of the RAS, Head of the Department of Internal Diseases Propedeutics; Director of V. Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology, University Clinical Hospital No. 2

8/2, Trubetskaya str., Moscow, 119991



O. Yu. Zolnikova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Oxana Yu. Zolnikova, MD, PhD, Associate Professor, Department of Internal Diseases Propedeutics

8/2, Trubetskaya str., Moscow, 119991

+7 (916) 391-69-56



A. A. Svistunov
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Andrey A. Svistunov, MD, PhD, DMSc, Professor, Corresponding Member of the RAS, First Vice-rector

8/2, Trubetskaya str., Moscow, 119991



N. L. Dzhakhaya
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Natiya L. Dzhakhaya, MD, PhD, Associate Professor, Department of Internal Diseases Propedeutics

8/2, Trubetskaya str., Moscow, 119991



N. D. Potskhverashvili
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Nino D. Potskhverashvili, MD, PhD, doctor, Pulmonology Department, V. Vasilenko Clinic for Internal Diseases Propedeutics, Gastroenterology and Hepatology, University Clinical Hospital No. 2

8/2, Trubetskaya str., Moscow, 119991



N. I. Kokina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Nataliya I. Kokina, MD, PhD, Head of the Pulmonology Department, V. Vasilenko Clinic for Internal Diseases Propedeutics, Gastroenterology and Hepatology, University Clinical Hospital No. 2; Associate Professor, Department of Internal Diseases Propedeutics

8/2, Trubetskaya str., Moscow, 119991



E. R. Buklis
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Elvira R. Buklis, MD, PhD, doctor, Pulmonology Department, V. Vasilenko Clinic for Internal Diseases Propedeutics, Gastroenterology and Hepatology, University Clinical Hospital No. 2

8/2, Trubetskaya str., Moscow, 119991



T. V. Roshchina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Tatyana V. Roshchina, MD, PhD, doctor, Pulmonology Department, of V. Vasilenko Clinic for Internal Diseases Propedeutics, Gastroenterology and Hepatology, University Clinical Hospital No. 2

8/2, Trubetskaya str., Moscow, 119991



I. I. Komkova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Inna I. Komkova, MD, PhD, doctor, Pulmonology Department, of V. Vasilenko Clinic for Internal Diseases Propedeutics, Gastroenterology and Hepatology, University Clinical Hospital No. 2

8/2, Trubetskaya str., Moscow, 119991



M. Yu. Nadinskaia
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Maria Yu. Nadinskaia, MD, PhD, Associate Professor, Department of Internal Diseases Propedeutics

8/2, Trubetskaya str., Moscow, 119991



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ISSN 2218-7332 (Print)
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