Early Short Course Corticosteroids in Hospitalized Patients with COVID-19.

Early Short Course Corticosteroids in Hospitalized Patients with COVID-19.

Publication date: May 19, 2020

There is no proven antiviral or immunomodulatory therapy for COVID-19. The disease progression associated with the pro-inflammatory host response prompted us to examine the role of early corticosteroid therapy in patients with moderate to severe COVID-19.

We conducted a single pre-test, single post-test quasi-experiment in a multi-center health system in Michigan from March 12 to March 27, 2020. Adult patients with confirmed moderate to severe COVID were included. A protocol was implemented on March 20, 2020 using early, short-course, methylprednisolone 0.5 to 1 mg/kg/day divided in 2 intravenous doses for 3 days. Outcomes of standard of care (SOC) and early corticosteroid groups were evaluated, with a primary composite endpoint of escalation of care from ward to ICU, new requirement for mechanical ventilation, and mortality. All patients had at least 14 days of follow-up.

We analyzed 213 eligible subjects, 81 (38%) and 132 (62%) in SOC and early corticosteroid groups, respectively.The composite endpoint occurred at a significantly lower rate in the early corticosteroid group (34.9% vs. 54.3%, p=0.005). This treatment effect was observed within each individual component of the composite endpoint. Significant reduction in median hospital length of stay was also observed in the early corticosteroid group (8 vs. 5 days, p

An early short course of methylprednisolone in patients with moderate to severe COVID-19 reduced escalation of care and improved clinical outcomes.

Concepts Keywords
Antiviral SARS
AOR Pro inflammatory host
Composite Endpoint Mechanical ventilation
Corticosteroid Glucocorticoids
Corticosteroids Steroids
Hospital Endocrine system
Immunomodulatory Health
Intravenous Corticosteroids
Mechanical Ventilation RTT
Methylprednisolone Endocrinology
Michigan Hormones
Mortality Methylprednisolone
Protocol Clinical endpoint
Regression
Ward

Semantics

Type Source Name
disease MESH disease progression
drug DRUGBANK Methylprednisolone

Original Article

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